Regurgitation is a complication common during cardiopulmonary resuscitation (CPR). This manikin study evaluated the effect of regurgitation during endotracheal intubation on CPR quality. An airway-CPR manikin was modified to regurgitate simulated gastric contents into the oropharynx during chest compression during CPR. In total, 54 emergency medical technician-paramedics were assigned to either an oropharyngeal regurgitation or clean airway scenario and then switched to the other scenario after finishing the first. The primary outcomes were CPR quality metrics, including chest compression fraction (CCF), chest compression depth, chest compression rate, and longest interruption time. The secondary outcomes were intubation success rate and intubation time. During the first CPR–intubation sequence, the oropharyngeal regurgitation scenario was associated with a significantly lower CCF (79.6% vs. 85.1%, P < 0.001), compression depth (5.2 vs. 5.4 cm, P < 0.001), and first-pass success rate (35.2% vs. 79.6%, P < 0.001) and greater longest interruption duration (4.0 vs. 3.0 s, P < 0.001) than the clean airway scenario. During the second and third sequences, no significant difference was observed in the CPR quality metrics between the two scenarios. In the oropharyngeal regurgitation scenario, successful intubation was independently and significantly associated with compression depth (hazard ratio = 0.47, 95% confidence interval, 0.24–0.91), whereas none of the CPR quality metrics were related to successful intubation in the clean airway scenario. Regurgitation during endotracheal intubation significantly reduces CPR quality. ClinicalTrials.gov, NCT05278923 , March 14, 2022.

中文翻译：

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气管插管过程中反流导致心肺复苏质量下降：一项随机交叉人体模型模拟研究

反流是心肺复苏术 (CPR) 期间常见的并发症。这项人体模型研究评估了气管插管过程中反流对 CPR 质量的影响。对气道 CPR 人体模型进行了修改，以在 CPR 期间的胸部按压期间将模拟的胃内容物反流到口咽中。总共有 54 名紧急医疗技术人员 - 护理人员被分配到口咽反流或清洁气道情景，然后在完成第一个情景后切换到另一种情景。主要结果是 CPR 质量指标，包括胸外按压分数 (CCF)、胸外按压深度、胸外按压率和最长中断时间。次要结果是插管成功率和插管时间。在第一次 CPR 插管过程中，口咽反流情况与显着降低的 CCF（79.6% vs. 85.1%，P < 0.001）、按压深度（5.2 vs. 5.4 cm，P < 0.001）和首次通过成功率（35.2% vs. 79.6 %, P < 0.001) 和更长的最长中断持续时间 (4.0 vs. 3.0 s, P < 0.001) 比清洁气道情景。在第二个和第三个序列中，两个场景之间的 CPR 质量指标没有观察到显着差异。在口咽返流情景中，成功插管与按压深度独立且显着相关（风险比 = 0.47，95% 置信区间，0.24-0.91），而 CPR 质量指标均与清洁气道情景中的成功插管无关。气管插管期间的反流会显着降低 CPR 质量。