Kim Jung Wan, Lee Jin Woong, Ryu Seung, Park Jung Soo, Yoo InSool, Cho Yong Chul, Ahn Hong Joon
Department of Emergency Medicine, Chungnam National University Hospital, Jung-gu, Daejeon, Republic of Korea.
Department of Emergency Medicine, College of Medicine, Chungnam National University, Jung-gu, Daejeon, Republic of Korea.
World J Emerg Med. 2020;11(2):97-101. doi: 10.5847/wjem.j.1920-8642.2020.02.006.
Adequate airway management plays an important role in high-quality cardiopulmonary resuscitation (CPR). Airway management is usually performed using an endotracheal tube (ETT) during CPR. However, no study has assessed the effect of ETT size on the flow rate and airway pressure during CPR.
We measured changes in peak inspiratory flow rate (PIFR), peak airway pressure (P), and mean airway pressure (P) according to changes in ETT size (internal diameter 6.0, 7.0, and 8.0 mm) and with or without CPR. A tidal volume of 500 mL was supplied at a rate of 10 times per minute using a mechanical ventilator. Chest compressions were maintained at a constant compression depth and speed using a mechanical chest compression device (LUCAS2, mode: active continuous, chest compression rate: 102±2/minute, chest compression depth 2-2.5 inches).
The median of several respiratory physiological parameters during CPR was significantly different according to the diameter of each ETT (6.0 vs. 8.0 mm): PIFR (32.1 L/min [30.5-35.3] vs. 28.9 L/min [27.5-30.8], P<0.001), P (48.84 cmHO [27.46-52.11] vs. 27.45 cmHO [22.53-52.57], P<0.001), and P (18.34 cmHO [14.61-21.66] vs.13.66 cmHO [8.41-19.24], P<0.001).
The changes in PIFR, P, and P were related to the internal diameter of ETT, and these values tended to decrease with an increase in ETT size. Higher airway pressures were measured in the CPR group than in the no CPR group.
充分的气道管理在高质量心肺复苏（CPR）中起着重要作用。在心肺复苏期间，气道管理通常通过气管内插管（ETT）进行。然而，尚无研究评估气管内插管尺寸对心肺复苏期间流速和气道压力的影响。
我们根据气管内插管尺寸（内径6.0、7.0和8.0毫米）的变化以及有无心肺复苏，测量了吸气峰流速（PIFR）、气道峰压（P）和平均气道压（P）的变化。使用机械通气机以每分钟10次的速率提供500毫升的潮气量。使用机械胸外按压装置（LUCAS2，模式：主动持续，胸外按压速率：102±2次/分钟，胸外按压深度2 - 2.5英寸）将胸外按压维持在恒定的按压深度和速度。
根据每个气管内插管的直径（6.0毫米与8.0毫米），心肺复苏期间几个呼吸生理参数的中位数有显著差异：PIFR（32.1升/分钟[30.5 - 35.3]与28.9升/分钟[27.5 - 30.8]，P<0.001），P（48.84厘米水柱[27.46 - 52.11]与27.45厘米水柱[22.53 - 52.57]，P<0.001），以及P（18.34厘米水柱[14.61 - 21.66]与13.66厘米水柱[8.41 - 19.24]，P<0.001）。
PIFR、P和P的变化与气管内插管的内径有关，并且这些值倾向于随着气管内插管尺寸的增加而降低。心肺复苏组的气道压力高于无心肺复苏组。
