Abstract 295: Gas Insufflation in the Stomach During Cardiopulmonary Resuscitation Using Laryngeal Tube Ventilation in Comparison with Bag-Valve-Mask Ventilation
Background: Gastric gas insufflation is one of the major complications during cardiopulmonary resuscitation (CPR) using bag-valve-mask ventilation (BVM). Among alternative airways, a laryngeal tube (LT) has an esophageal cuff to avoid not only regurgitation of the gastric content, but also gastric gas insufflation. However, the efficacy of this device for preventing the latter complication during CPR remains unknown.
Objective: We aimed to compare the gastric gas volumes of patients with out-of-hospital cardiac arrest (OHCA) who received CPR with either BVM or LT ventilation in a prehospital setting.
Methods: This was a retrospective analysis using patient data. From January 2010 to December 2011, 148 OHCA patients with either BVM or LT ventilation were enrolled. We used computed tomographic (CT) scans to measure the gastric gas volume. The pulmonary infiltrates on CT were also evaluated as an indication of pulmonary aspiration. A nasogastric tube was not placed in the patients before CT.
Results: The patient background data are shown in the table. Fifty-nine (40%) had BVM ventilation (BVM group) and 89 (60%) had LT ventilation (LT group). The time spent at the scene was longer in the LT group than in the BVM group (p<0.001). The mean gas volumes in the stomach in the BVM and LT groups were 370.7±344.2 and 388.5±418.4 ml, respectively, with no significant difference. No significant differences were observed in the incidence of pulmonary infiltrates on CT between the groups.
Conclusions: We did not find any differences in the gastric gas volume and incidence of pulmonary aspiration between the BVM and LT groups. These data question the effectiveness of LT ventilation for preventing gastric gas insufflation during CPR. Further studies are required to confirm these findings.
- © 2012 by American Heart Association, Inc.