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Abstract
Background There is controversy about the optimal device for airway management during CPR. The International Liaison Committee on Resuscitation latest recommendations in 2015,1 has raised doubts about the surveillance of the patients ventilated by advanced versus basic airways by means Bag-Valve-Mask (BVM), also a recent randomized trial seems to corroborate this findings.2 The aim of our trial is to assess the quality of ventilation between Bag-Valve-Mask versus laryngeal Mask through capnography values obtained during Basic instrumental CPR.
Method Prospective cluster-randomized and open-label trial, realized in the Prehospital Emergency Medical Service 061 Balearic Islands, Spain. The Emergency Technicians of the 4 Basic Life Support ambulances (BLS) included in the trial were instructed in the use of capnography within BVM or I-Gel ventilation and randomized in two branches (BVM or I-Gel) in pairs. We exchanged the airway management for each group every 4 months.
Results During the first six months of the study, 15 patients were assisted by the BLS units, of these 8 were enrolled (4 in every branch) with enough capnography values during the initial 9 min of CPR. The mean ±SD in the BVM branch was 13±8,41 mmHg; in case of the I-Gel branch was 24±6,5 mmHg. Three patients were survivors, 2 with the I-Gel and 1 in the BVM.
Conclusion Prehospital airway management during CPR via I-Gel seems to provide better ventilation than BVM reflected by capnography values in the first data obtained from our sample.
References
Callaway CW, Soar J, Aibiki M, Bottiger BW, Brooks SC, Deakin CD, et al. Part 4: Advanced Life Support: 2015 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations. Circulation 2015 Oct;132(16 Suppl 1):S84–145.
Jabre P, Penaloza A, Pinero D, Duchateau F-XX, Borron SW, Javaudin F, et al. Effect of bag-mask ventilation vs endotracheal intubation during cardiopulmonary resuscitation on neurological outcome after out-of-hospital cardiorespiratory arrest a randomized clinical trial. JAMA - J Am Med Assoc 2018 Feb;319(8):779–87.
Conflict of interest None.
Funding This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.
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