Amsterdam UMC location Vrije Universiteit Amsterdam, Anesthesiology, De Boelelaan 1117, Amsterdam, the Netherlands; Amsterdam Public Health, Quality of Care, Amsterdam, the Netherlands.
Amsterdam UMC location University of Amsterdam, Anesthesiology, Meibergdreef 9, Amsterdam, the Netherlands; Amsterdam Public Health, Quality of Care, Amsterdam, the Netherlands.
Resuscitation. 2024 Oct;203:110366. doi: 10.1016/j.resuscitation.2024.110366. Epub 2024 Aug 23.
Ventilation during cardiopulmonary resuscitation is vital to achieve optimal oxygenation but continues to be a subject of ongoing debate. This narrative review aims to provide an overview of various components and challenges of ventilation during cardiopulmonary resuscitation, highlighting key areas of uncertainty in the current understanding of ventilation management. It addresses the pulmonary pathophysiology during cardiac arrest, the importance of adequate alveolar ventilation, recommendations concerning the maintenance of airway patency, tidal volumes and ventilation rates in both synchronous and asynchronous ventilation. Additionally, it discusses ventilation adjuncts such as the impedance threshold device, the role of positive end-expiratory pressure ventilation, and passive oxygenation. Finally, this review offers directions for future research.
心肺复苏期间的通气对于实现最佳氧合至关重要,但它仍然是一个持续存在争议的话题。本叙述性综述旨在概述心肺复苏期间通气的各个组成部分和挑战,强调当前对通气管理理解中存在不确定性的关键领域。它涉及心脏骤停期间的肺病理生理学、充分肺泡通气的重要性、关于同步和异步通气时气道通畅性、潮气量和通气率维持的建议。此外,它还讨论了通气辅助手段,如阻抗阈设备、呼气末正压通气的作用以及被动氧合。最后,本综述为未来的研究提供了方向。