Don’t forget to ventilate during cardiopulmonary resuscitation with mechanical chest compression devices

Should we resuscitate or not—that is the question!

“…However, we would caution that etCO 2 levels should be interpreted in light of automated mechanical chest compression devices (ACCD) and the choice of airway device. We recently criticized that there is considerable potential for ineffective ventilation with continuous and uninterrupted mechanical chest compressions in patients ventilated via supraglottic airway devices (17). This may be particularly important for patients transported to a hospital with prolonged and ongoing CPR during transport (17).…”

“…We recently criticized that there is considerable potential for ineffective ventilation with continuous and uninterrupted mechanical chest compressions in patients ventilated via supraglottic airway devices (17). This may be particularly important for patients transported to a hospital with prolonged and ongoing CPR during transport (17). No such data are reported in the study by Kashiura et al (13).…”

Out-of-hospital airway management during manual compression or automated chest compression devices

“…Although not investigated in the present study, ventilation problems might occur in the setting of SAD use during ACCD. In the authors' clinical experience, ACCD makes continuous high-quality ventilation difficult and sometimes impossible [10]. None of the available ACCD cited in the ERC guidelines were constructed with particular regard to effective and safe ventilation [3].…”

“…In Europe, there has also been an increase in the use of ACCD. The three major randomized controlled trials on the use of ACCD, the CIRC [6], LINC [7] and PARAMEDIC [8] trials and other [9] did not show a benefit of ACCD over manual chest compression (mCC) in OHCA; however, they also did not reveal any profound risks or evidence of inferiority of ACCD; therefore, problems with the use of ACCD have significant implications for patient safety and are of major interest for the scientific community [10]. Data and recommendations concerning airway strategy and the compression to ventilation ratio during ACCD use on outcome of OHCA are missing [10].…”

Anwendung des Larynxtubus in der Notfallmedizin – Komplikationen und Fallstricke

“…Auf die Probleme der Oxygenierung und Ventilation über extraglottische Atemwege bei der Anwendung von automatischen externen Reanimationshilfen (ACCD, z. B. LUCAS, Autopuls) wurde bereits in früheren Publikationen hingewiesen [30]. Diese Kombination kann zu einer verhängnisvollen und insuffizienten Ventilation mit konsekutiver Hyperkapnie führen.…”