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Inicio Revista Española de Anestesiología y Reanimación (English Edition) Minimum oxygen flow needed for vital support during simulated post-cardiorespira...
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Vol. 63. Issue 5.
Pages 261-266 (May 2016)
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Vol. 63. Issue 5.
Pages 261-266 (May 2016)
Original article
DOI: 10.1016/j.redare.2015.12.002
Minimum oxygen flow needed for vital support during simulated post-cardiorespiratory arrest resuscitation
Mínimo flujo de oxígeno necesario para soporte vital durante la simulación de reanimación post parada cardiorrespiratoria
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E. Sanz-Sanjoséa,
Corresponding author
e.sanz.sanjose@gmail.com

Corresponding author.
, J.J. Ariño Irujob, C.E. Sánchez Martína, C. González Perrinoa, F. López-Timonedaa
a Servicio de Anestesiología y Reanimación, Hospital Clínico San Carlos, Madrid, Spain
b Servicio de Anestesiología y Reanimación, Al Noor Hospital, Khalifa Branch, Abu Dabi, United Arab Emirates
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Table 1. Lower limit of confidence interval of mean FiO2 (%) using four different oxygen flow rates and four different resuscitators.
Abstract

According to the ERC and the AHA guidelines, FiO2 should be titrated to achieve an O2Sat94%. The aim of this study was to determine the minimum oxygen flow and time needed to reach an FiO2 of 0.32 and 0.80 during post-cardiac arrest care. An experimental analysis was performed that consisted of a simulated post-cardiac arrest situation. Different resuscitators were tested and connected to an artificial lung: Mark IV, SPUR II, Revivator Res-Q, O-TWO. The oxygen flow levels tested were 2, 5, 10 and 15lpm. Bonferroni and Mann–Whitney U tests were used. An FiO2 of 0.32 or more was obtained using any of the oxygen flow and resuscitators. Only the Mark IV achieved an FiO2 of 0.80 after a minimum of 75s ventilating with 2 or 5lpm. Clinical and statistical differences (p<.05) were found: at 15lpm it took 35s to reach an FiO2 of 0.80 or more for Mark IV (85.6 [0.3]) and Revivator (84.3 [1.5]) compared to 50s for SPUR II (87.1 [6.4]); at 2lpm, all of the devices reached an FiO2 of0.32 at 30s (Mark IV (34.8 [1.3]), Revivator (35.7 [1.5]) and SPUR II (34.4 [2.1]), except for O-TWO, which took 35s (36.3 [4.3]). Patients could be ventilated with any of the resuscitators using 2lpm to obtain an FiO2 of 0.32, although possibly O-TWO would be the last option during the first 60s. In order to reach an FiO2 of 0.80, ventilating with 10lpm should be sufficient, and preferably using Mark IV or Revivator Res-Q. In conclusion, on observing the results of our study, in any possible scenario, it would be advisable to use Revivator Res-Q or Mark IV rather than O-TWO or SPUR II.

Keywords:
Cardiopulmonary resuscitation
Fraction of inspired oxygen
Bag valve mask device
Resumen

De acuerdo con las guías de la AHA y la ERC, la FiO2 a administrarse debería ser aquella con la que se obtuviera una SatO294%. El objetivo de este estudio es determinar el mínimo flujo de oxígeno y tiempo necesarios para alcanzar una FiO2 de 0,32 y de 0,80 durante el manejo posparada cardiaca. Se emplearon diferentes reanimadores, que fueron conectados a un pulmón artificial: Mark IV, SPUR II, Revivator Res-Q, O-TWO. Los flujos de oxígeno probados fueron 2, 5, 10 y 15lpm. Los test estadísticos aplicados fueron Bonferroni y U de Mann-Whitney. Se obtuvo una FiO20,32 con cualquiera de los flujos de oxígeno y reanimadores. Tras un mínimo de 75s ventilando con 2 o 5lpm, solo se consiguió una FiO2 de 0,80 con Mark IV. Se hallaron diferencias clínica y estadísticamente significativas (p<0,05): con 15lpm se necesitaron 35s para alcanzar una FiO20,80 con Mark IV (85,6 [0,3]) y Revivator (84,3 [1,5]) comparado con los 50s que precisó SPUR II (87,1 [6,4]); con 2lpm, todos los resucitadores alcanzaron una FiO20,32 en 30s(Mark IV (34,8 [1,3]), Revivator (35,7 [1,5]) y SPUR II (34,4 [2,1]), excepto O-TWO, que necesitó 35s (36,3 [4,3]). Para alcanzar una FiO2 de 0,32 se podría emplear cualquiera de los resucitadores usando 2lpm, aunque quizá el menos recomendable sería O-TWO. Si el objetivo fuera una FiO2 de 0,80, debería bastar con 10lpm, usando preferiblemente Mark IV o Revivator Res-Q. En conclusión, atendiendo a los resultados de nuestro estudio, ante cualquier situación potencial, sería preferible emplear Revivator Res-Q o Mark IV que O-TWO o SPUR II.

Palabras clave:
Reanimación cardiopulmonar
Fracción inspirada de oxígeno
Resucitador

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