Aim

Mechanical chest compression devices in the 30:2 mode generally provide a pause of three seconds to give two insufflations without evidence supporting this pause duration. We aimed to explore the optimal pause duration by measuring the time needed for two insufflations, during advanced life support with manual compressions.

Methods

Prospectively collected data in the AmsteRdam REsuscitation STudies (ARREST) registry were analysed, including thoracic impedance signal and waveform capnography from manual defibrillators of the Amsterdam ambulance service. Compression pauses were analysed for number of insufflations, time interval from start of the compression pause to the end of the second insufflation, chest compression pause duration and ventilation subintervals.

Results

During 132 out-of-hospital cardiac arrests, 1619 manual chest compression pauses to ventilate were identified. In 1364 (84%) pauses, two insufflations were given. In 28% of these pauses, giving two insufflations took more than three seconds. The second insufflation is completed within 3.8 seconds in 90% and within 5 seconds in 97.5% of these pauses. An increasing likelihood of achieving two insufflations is seen with increasing compression pause duration up to five seconds.

Conclusion

The optimal chest compression pause duration for mechanical chest compression devices in the 30:2 mode to provide two insufflations, appears to be five seconds, warranting further studies in the context of mechanical chest compression. A 5-second pause will allow providers to give two insufflations with a very high success rate. In addition, a 5-second pause can also be used for other interventions like rhythm checks and endotracheal intubation.

中文翻译：

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院前高级生命支持期间通气的手动胸外按压暂停持续时间——一项探索机械胸外按压设备最佳通气暂停持续时间的观察性研究

目的

30:2 模式下的机械胸部按压设备通常会提供三秒的暂停以进行两次吹气，但没有证据支持该暂停持续时间。我们的目的是通过测量手动按压高级生命支持期间两次吹气所需的时间来探索最佳暂停持续时间。

方法

对 AmsteRdam 复苏研究 (ARREST) 登记册中前瞻性收集的数据进行了分析，包括来自阿姆斯特丹救护车服务手动除颤器的胸廓阻抗信号和波形二氧化碳图。分析按压暂停的充气次数、从按压暂停开始到第二次充气结束的时间间隔、胸部按压暂停持续时间和通气子间隔。

结果

在 132 例院外心脏骤停期间，发现了 1619 例手动胸外按压暂停通气的情况。在 1364 次（84%）暂停中，进行了两次吹气。在 28% 的暂停中，两次吹气需要超过三秒。其中 90% 的第二次充气在 3.8 秒内完成，97.5% 的第二次充气在 5 秒内完成。随着压缩暂停持续时间增加至五秒，实现两次吹气的可能性越来越大。

结论

机械胸外按压设备在 30:2 模式下提供两次吹气的最佳胸外按压暂停持续时间似乎为 5 秒，值得在机械胸外按压的背景下进行进一步研究。5 秒的暂停将允许提供者以非常高的成功率进行两次吹气。此外，5秒暂停还可以用于其他干预措施，例如心律检查和气管插管。