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Yearbook of Intensive Care and Emergency Medicine 2010 pp 75–82Cite as

Airway and Ventilation during CPR

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Part of the book series: Yearbook of Intensive Care and Emergency Medicine ((YEARBOOK,volume 2010))

Abstract

The primary components of standard cardiopulmonary resuscitation (CPR) are chest compressions to circulate blood, defibrillation to convert a ‘shockable’ rhythm into one that will produce a spontaneous circulation, and ventilation of the lungs to enable oxygenation of the blood and removal of carbon dioxide (CO2). Effective ventilation of the lungs requires a patent airway, while protection of the lungs from aspiration of gastric contents requires reliable separation of the gastrointestinal tract from the airway. Traditionally, the single airway device deemed capable of maintaining airway patency and protecting from aspiration is the tracheal tube. However, the unique status of tracheal intubation is now being challenged. Tracheal intubation is associated with several complications and it is possible that it would be better for healthcare professionals who are not highly skilled in this intervention to use alternative airway devices. After primary cardiac arrest, based mainly on animal data, but also on some low-level human data, ventilation may not be necessary for several minutes. Recent observational clinical studies suggest that chest compression-only CPR by bystanders results in the same or better outcomes than bystander CPR that includes both mouth-to-mouth breathing and chest compressions. There are data indicating that excessive ventilation is harmful during CPR and, possibly, after return of spontaneous circulation. This chapter will focus on the evidence supporting new strategies for management of the airway and ventilation during CPR.

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Author information

Authors and Affiliations

  1. Department of Anesthesiology and Intensive Care Medicine, Royal United Hospital, Combe Park, Bath, BA1 3NG, UK

    J. P. Nolan

  2. Department of Anesthesiology and Intensive Care Medicine, Southmead Hospital, Bristol, BS10 5NB, UK

    J. Soar

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  1. J. P. Nolan
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Editors and Affiliations

  1. Department of Intensive Care Erasme Hospital, Université libre de Bruxelles, Route de Lennik 808, B-1070, Brussels, Belgium

    Jean-Louis Vincent (Head) (Head)

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Nolan, J.P., Soar, J. (2010). Airway and Ventilation during CPR. In: Vincent, JL. (eds) Yearbook of Intensive Care and Emergency Medicine 2010. Yearbook of Intensive Care and Emergency Medicine, vol 2010. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-10286-8_8

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  • DOI: https://doi.org/10.1007/978-3-642-10286-8_8

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  • Print ISBN: 978-3-642-10285-1

  • Online ISBN: 978-3-642-10286-8

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