Patients with cardiac arrest are ventilated two times faster than guidelines recommend: an observational prehospital study using tracheal pressure measurement

Abstract

Aim: To measure ventilation rate using tracheal airway pressures in prehospitally intubated patients with and without cardiac arrest.

Methods: Prospective observational study. In 98 patients (57 with and 41 without cardiac arrest) an air-filled catheter was inserted into the endotracheal tube and connected to a custom-made portable device allowing tracheal airway pressure recording and subsequent calculation of ventilation rate.

Results: In manually ventilated patients with cardiac arrest 39/43 (90%) had median ventilation rates higher than 10/min (overall median 20, min 4, max 74). During mechanical ventilation, 35/38 (92%) had ventilation rates higher than 10/min. The ventilation rate in patients with cardiac arrest was higher than in patients without cardiac arrest, both for manual and mechanical ventilation. Subanalysis comparing episodes with and without compression in cardiac arrest patients showed no clinically significant difference in ventilation rate after compressions were terminated.

Conclusion: Cardiac arrest patients were ventilated two times faster than recommended by the guidelines. Tracheal airway pressure measurement is feasible during resuscitation and may be developed further to provide real-time feedback on airway pressure and ventilation rate during resuscitation.