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Chapter: Clinical Cases in Anesthesia : Cardiopulmonary Resuscitation

What are the recommended rates of compression and ventilation?

Animal models of CPR have shown that the optimal blood flows are achieved when chest compressions are performed at 80–100 times per minute and the chest is compressed 1.5 to 2 inches (3–5 cm).

What are the recommended rates of compression and ventilation?

 

Animal models of CPR have shown that the optimal blood flows are achieved when chest compressions are performed at 80–100 times per minute and the chest is compressed 1.5 to 2 inches (3–5 cm). The new Guidelines for Cardiopulmonary Resuscitation published by the American Heart Association in 2000 recommend a chest compression rate of 100 times per minute. The proportion of time spent during the compression phase should be 50% of the relaxation phase.

 

Artificial ventilation is preferentially given by endotra-cheal tube (ETT) at a rate of 10–12 breaths per minute. Nevertheless, the new ACLS guidelines de-emphasize endo-tracheal intubation during CPR due to a high incidence of incorrectly placed ETTs. Mask ventilation or alternative air-ways, such as the laryngeal mask or the esophageal-tracheal Combitube, may be preferable in situations where the rescuer is not properly trained or skilled in ETT placement. It is now mandatory to confirm correct ETT placement by both physical examination and a secondary device, such as capnography, a colorimetric carbon dioxide (CO2) detector, or an esophageal detector device. During two-person CPR, ventilation in the intubated patient should be performed with every fifth compression. With an unprotected airway or during one-rescuer CPR the compression to ventilation ratio is 15:2. 



Each breath should take about 2 seconds and should make the chest rise clearly. Animal studies demon-strate higher cerebral perfusion pressures when ventilation occurs simultaneously with compressions. However, improved survival has not been demonstrated in humans, and this technique is not recommended.

 

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Clinical Cases in Anesthesia : Cardiopulmonary Resuscitation : What are the recommended rates of compression and ventilation? |


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