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Intensive Care Med. 2006 Jun;32(6):843-51. Epub 2006 Apr 28.

Constant flow insufflation of oxygen as the sole mode of ventilation during out-of-hospital cardiac arrest.

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1
Henri Mondor Hospital, Paris 12 University, Department of Anesthesiology and Emergency Medical Service of Creteil, AP-HP, Creteil, France. catherine.bertrand@hmn.aphp.fr

Abstract

BACKGROUND:

Constant flow insufflation of oxygen (CFIO) through a Boussignac multichannel endotracheal tube has been reported to be an efficient ventilatory method during chest massage for cardiac arrest.

METHODS:

Patients resuscitated for out-of-hospital cardiac arrest were randomly assigned to standard endotracheal intubation and mechanical ventilation (MV; n =457) or use of CFIO at a flow rate of 15 l/min (n=487). Continuous chest compressions were similar in the two groups. Pulse oximetry level was recorded every 5[Symbol: see text]min. Outcome of initial resuscitation, hospital admission, complications, and discharge from the intensive care unit (ICU) were analyzed. The randomization scheme was changed during the study, but the in-depth analysis was performed only on the first cohort of 341 patients with CFIO and 355 with MV, because of randomization problems in the second part.

RESULTS:

No difference in outcome was noted regarding return to spontaneous circulation (CFIO 21%, MV 20%), hospital admission (CFIO 17%, MV 16%), or ICU discharge (CFIO 2.4%, MV 2.3%). The level of detectable pulse saturation and the proportion of patients with saturation above 70% were higher with CFIO. Ten patients with MV but only one with CFIO had rib fractures.

CONCLUSIONS:

CFIO is a simplified alternative to MV, with favorable effects regarding oxygenation and fewer complications, as observed in this group of patients with desperate prognosis.

PMID:
16715326
DOI:
10.1007/s00134-006-0137-2
[Indexed for MEDLINE]
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