Effect of continuous oxygen insufflation on induced-gastric air volume during cardiopulmonary resuscitation in a cadaveric model

Gastric insufflation during cardiopulmonary resuscitation: A study in human cadavers

“…Unfortunately, these studies evaluated gastric inflation only during interrupted CC in models far from the physiological conditions of a real cardiac arrest patient (7,22,23). The substantial amount of gastric insufflation reported in the present study during the 30:2 strategy is high but consistent with findings already obtained in a cadaver model (24). In this study, the authors demonstrated that continuous CC associated with continuous flow insufflation (generating positive pressure with no additional bag ventilation) significantly reduced gastric insufflation compared to the conventional bag mask 30:2 interrupted chest compression strategy.…”

“…However, the lower esophageal opening pressure reported in the present study is higher than previously described immediately after death (25,26) and this may have interfered with our results by limiting gastric insufflation. Second, the method we used to assess gastric insufflation along time, previously reported by Segal et al (24)(i.e., a surgical gastrostomy) may have limited stomach distension because the gastrostomy works as a leak, and result in a lower impact on ventilation. However, our additional experiment preserving the integrity of the stomach shows consistent result by directly measuring gastric pressure change.…”

Ventilation During Cardiopulmonary Resuscitation: What Have We Learned From Models?

“…18 Recently, fresh and treated cadavers have been proposed as a model for studying CPR. 35 Among these, soft embalmed Thiel cadavers, which retain the body's natural look and feel, are reported to reliably reproduce human respiratory mechanics during cardiac arrest, thereby allowing realistic measurement during CPR. 36,37 One important advantage of the human cadaver model, besides its capacity to reflect human respiratory physiology, is the possibility to measure the intrathoracic pressure changes (ie, the pressure that drives the vascular pressure produced by chest compressions) with the help of esophageal manometry.…”

Cadaver models for cardiac arrest: A systematic review and perspectives

“…No preparation or declotting is performed. In this systematic review, 16 (55%) studies used fresh cadavers, and these records studied six main research areas: airway management, seven studies (44%) [24][25][26][27][28][29][30]; mechanical properties of the chest, three studies (19%) [17,31,32]; haemodynamics, two studies (12.5%) [33,34]; defibrillation safety, two studies (12.5%) [22,35], intraosseous access, one study (6%) [36]; and one study explored bispectral index monitoring and used a fresh cadaver for artefact control (6%) [37]. The main advantages reported of using fresh cadavers were: its accurate morphology and tissue conservation making it possible, for example, to reflect the conditions of endotracheal intubation, accurately estimate regurgitation risks in humans having CPR, obtain a stable transthoracic impedance over time and characterise thoracic viscoelastic properties.…”