Objective This study was conducted to determine why rescuers could maintain adequate chest compression depth for longer periods during conventional cardiopulmonary resuscitation (CPR).
Methods Various CPR parameters, including average compression depth (ACD), average compression rate, average ventilation time (AVT), and rescuers’ heart rates were recorded in real-time when 20 health care providers performed 10 minutes of conventional CPR during a simulation experiment.
Results The ACD was maintained above 50 mm and was not significantly different during 19 consecutive CPR cycles. The average compression rate increased from 114.9±10.0/min (2nd cycle) to 120.1±13.8/min (18th cycle) (P=0.007), and the AVT increased from 8.7±1.5 seconds (3rd cycle) to 10.1±2.6 seconds (18th cycle) (P=0.002). The rescuers’ heart rates also increased gradually for 10 min; however, they increased rapidly and were highest during the ventilation phase. Their heart rates then decreased and were lowest during the early chest compression phases of each CPR cycle. Decreases in heart rates were significant in all CPR cycles (average decrease: 14.5±4.5 beats/min, P<0.001).
Conclusion The ACD was maintained adequately during 10 minutes of conventional CPR. However, the AVT increased significantly during the 10-minute period. The rescuers’ heart rates increased and decreased throughout all CPR cycles. These results showed that the ventilation phase might play a role as a resting period and be a reason for the maintenance of adequate chest compression depth for prolonged periods during conventional CPR.
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Comparison of the effects of shortening rest intervals on the quality of cardiopulmonary resuscitation, physiological parameters, and hemodynamic parameters in well-trained rescuers Dong Hun Kim, Sang-Min Lee, Gyun Moo Kim, Kyung Woo Lee, Seung Hyun Ko, Ye Jin Oh, Young Woo Seo, Suk Hee Lee, Tae Chang Jang Medicine.2021; 100(6): e24666. CrossRef
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Physiological Response of Quality Cardiopulmonary Resuscitation, Crossover Trial on Mannequin in Extreme Temperature Conditions José Luis Martin-Conty, Begoña Polonio-López, Clara Maestre-Miquel, Alicia Mohedano-Moriano, Carlos Durantez-Fernández, Laura Mordillo-Mateos, Jesús Jurado-Palomo, Antonio Viñuela, Juan José Bernal-Jiménez, Francisco Martin-Rodríguez International Journal of Environmental Research and Public Health.2020; 17(16): 5835. CrossRef
Objective Our aim was to compare the compression quality, exercise intensity, and energy expenditure in 5-minute single-rescuer cardiopulmonary resuscitation (CPR) using 15:1 or 30:2 compression-to-ventilation (C:V) ratios or chest compression only (CCO).
Methods This was a randomized, crossover manikin study. Medical students were randomized to perform either type of CPR and do the others with intervals of at least 1 day. We measured compression quality, ratings of perceived exertion (RPE) score, heart rate, maximal oxygen uptake, and energy expenditure during CPR.
Results Forty-seven students were recruited. Mean compression rates did not differ between the 3 groups. However, the mean percentage of adequate compressions in the CCO group was significantly lower than that of the 15:1 or 30:2 group (31.2±30.3% vs. 55.1±37.5% vs. 54.0±36.9%, respectively; P<0.001) and the difference occurred within the first minute. The RPE score in each minute and heart rate change in the CCO group was significantly higher than those of the C:V ratio groups. There was no significant difference in maximal oxygen uptake between the 3 groups. Energy expenditure in the CCO group was relatively lower than that of the 2 C:V ratio groups.
Conclusion CPR using a 15:1 C:V ratio may provide a compression quality and exercise intensity comparable to those obtained using a 30:2 C:V ratio. An earlier decrease in compression quality and increase in RPE and heart rate could be produced by CCO CPR compared with 15:1 or 30:2 C:V ratios with relatively lower oxygen uptake and energy expenditure.
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Effect of 24-h Shifts on Cardiopulmonary Resuscitation Performance and Fatigue: A Simulation-Based Study Abdul Samet Sahin, Emre Dilaver, Kaan Basar Candas, Ozgen Gonen Cekic, Muhammet Fatih Beser, Melih Imamoglu, Sinan Pasli The Journal of Emergency Medicine.2026; 82: 99. CrossRef
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Correlation between real-time heart rate and fatigue in chest compression providers during cardiopulmonary resuscitation Go Eun Bae, Arom Choi, Jin Ho Beom, Min Joung Kim, Hyun Soo Chung, In Kyung Min, Sung Phil Chung, Ji Hoon Kim Medicine.2021; 100(16): e25425. CrossRef
Modified Two-Rescuer CPR With a Two-Handed Mask-Face Seal Technique Is Superior To Conventional Two-Rescuer CPR With a One-Handed Mask-Face Seal Technique Louis Gerber, Martin Botha, Abdullah E. Laher The Journal of Emergency Medicine.2021; 61(3): 252. CrossRef
Quality of chest compressions during pediatric resuscitation with 15:2 and 30:2 compressions-to-ventilation ratio in a simulated scenario Gema Manrique, Araceli González, Maitane Iguiñiz, Ana Grau, Blanca Toledo, Miriam García, Jesús López-Herce Scientific Reports.2020;[Epub] CrossRef
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Physiological Response of Quality Cardiopulmonary Resuscitation, Crossover Trial on Mannequin in Extreme Temperature Conditions José Luis Martin-Conty, Begoña Polonio-López, Clara Maestre-Miquel, Alicia Mohedano-Moriano, Carlos Durantez-Fernández, Laura Mordillo-Mateos, Jesús Jurado-Palomo, Antonio Viñuela, Juan José Bernal-Jiménez, Francisco Martin-Rodríguez International Journal of Environmental Research and Public Health.2020; 17(16): 5835. CrossRef
How Health Habits Influence the Physiological Response During a Physical Activity in Extreme Temperatures? José Luis Martin-Conty, Francisco Martin-Rodríguez, Juan José Criado-Álvarez, Carlos Alberto Castillo-Sarmiento, Clara Maestre-Miquel, Alicia Mohedano-Moriano, Begoña Polonio-López, Carlos Durantez-Fernández, Miguel Ángel Castro-Villamor, Antonio Viñuela International Journal of Environmental Research and Public Health.2020; 17(17): 6374. CrossRef
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Objective Pulmonary edema is frequently observed after a successful resuscitation in out-of hospital cardiac arrest (OHCA) patients. Currently, its risk factors and prognostic implications are mostly unknown.
Methods Adult OHCA patients with a presumed cardiac etiology who achieved sustained return of spontaneous circulation (ROSC) in emergency department were retrospectively analyzed. The patients were grouped according to the severity of consolidation on their initial chest X-ray (group I, no consolidation; group II, patchy consolidations; group III, consolidation involving an
entire lobe; group IV, total white-out of any lung). The primary objective was to identify the risk factors of developing severe pulmonary edema (group III or IV). The secondary objective was to evaluate the association between long-term prognosis and the severity of pulmonary edema.
Results One hundred and seven patients were included. Total duration of cardiopulmonary resuscitation (CPR) and initial pCO2 level were both independent predictors of developing severe pulmonary edema with their odds ratio (OR) being 1.02 (95% confidence interval [CI], 1.00 to 1.04; per 1 minute) and 1.04 (95% CI, 1.01 to 1.07; per 1 mmHg), respectively. The long term
prognosis was significantly poor in patients with severe pulmonary edema with a OR for good outcome (6-month cerebral performance category 1 or 2) being 0.22 (95% CI, 0.06 to 0.79) in group III and 0.16 (95% CI, 0.04 to 0.63) in group IV compared to group I.
Conclusion The duration of CPR and initial pCO2 level were both independent predictors for the development of severe pulmonary edema after resuscitation in emergency department. The severity of the pulmonary edema was significantly associated with long-term outcome.
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