b-card symposium

ILCOR 2015 & CPR-Ventilation Continuous 02 Insufflation in Cardiac Arrest

TuesdayMarch 7th

2017

Nicolas PESCHANSKI, MD, PhD

Acknowledgments

Salim R. Rezaie, MD@srrezaie

Justin L. Benoit, MD@justinleebenoit

ILCOR Cardiac Arrest Ventilation

Callaway CW et al. Circulation 2015

Chain-Of-Survival

Soar J et al. Resuscitation 2015

Missing Link

or

Weak Link?

ILCOR2015

CPR-Ventilation

Ewy GA et al. JACC 2009

Chain-Of-SurvivalILCOR2015

ILCOR2015

Give

O2

Callaway CW et al. Circulation 2015

ILCOR2015 Advanced Airway

10”

Deakin CD et al. Resuscitation 2010

EtCO2

ILCOR2015

Ahrens T et al. Am J Crit Care 2001

20’

Negative Factors

Rhythm <100/min

Interruptions

Depth <2’

Hyperventilation

ILCOR2015

Travers AH et al. Circulation 2010

RealLife

Hyper

Ventilation

Aufderheide TP et al. Circulation 2004

Do we hyperventilate?

RealLife

Pressure

O’Neill JF et al. Resuscitation 2007

Bag-Valve-Mask

Inflation Rate

Airway

Mean

➘PerfusionPressure

ILCOR2015

➘CoronaryPerfusion

➚Vent’

Berg RA et al. Circulation 2010

➚Chest Comp’Interruptions

ILCOR2015

“Everything should be made

as simple as possible,

but not simpler”

Hands-Only

CPR

Rea TD et al. NEJM 2010Bobrow BJ et al. JAMA 2010

RealLife

Passive Oxygen Delivery

Bobrow BJ et al. Annals Emerg Med 2009

Passive Oxygen Delivery

Saissy JM et al. Anesthesiology 2000

Passive Oxygen Delivery

Recommendations Grade IIb LOE C

Boussignac©

Cardiac

Arrest Tube

Continuous O2 INSUFFLATION

Bertrand C et al. Intens Care Med 2006

Concept

CardiacArrestTube

Steen S et al. Resuscitation 2004

Results

AnimalStudy

CIO vs. PPV

➚ROSC

Steen S et al. Resuscitation 2004

AnimalStudy

➚Coronary Perfusion

CIO vs. PPV

RealLife

MICU

No➚Vent’

ILCOR2015

First Responders / EMT

No CIO!

ILCOR2020

Is There A

Next Step?

Maybe…

ILCOR2020

Virtual valve

15 L/min

Same Concept

Same Concept

Lab Tests

Negative Pressure

Cadavers’ Study

Segal N et al. Resuscitation 2015

CPR-Induced Gastric Air➘

COIEffects

New RecommendationsIn Cardiac Arrest

Oxygenation?

Bag-Valve-Mask Can Be Bad

for CPR-Ventilation

Advanced-Airway Can Be Bad

for CPR-Ventilation

CPR-Ventilation

Is Compulsory!

CPR-Ventilation=

CPR-Designed Devices!

b-card symposium

Thank You for Your AttentionQ & A

TuesdayMarch 7th

2017

Nicolas PESCHANSKI, MD, PhD