Effect of automated head-thorax elevation during chest compressions on lung ventilation: a model study

Our goal was to investigate the effects of head-thorax elevation (HUP) during chest compressions (CC) on lung ventilation. A prospective study was performed on seven human cadavers. Chest was automatically compressed-decompressed in flat position and during progressive HUP from 18 to 35°. Lung venti...

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Bibliographic Details
Published in:Scientific reports 2023-11, Vol.13 (1), p.20393-20393, Article 20393
Main Authors: Duhem, Hélène, Terzi, Nicolas, Segond, Nicolas, Bellier, Alexandre, Sanchez, Caroline, Louis, Bruno, Debaty, Guillaume, Guérin, Claude
Format: Article
Language:English
Subjects:
631/443/1784
692/308/2778
Cadaver
Cadavers
Chest
Electric Impedance
Electrical impedance
Humanities and Social Sciences
Humans
Impedance
Life Sciences
Lung
Mechanical ventilation
multidisciplinary
Positive-Pressure Respiration - adverse effects
Prospective Studies
Respiration, Artificial
Science
Science (multidisciplinary)
Thorax - diagnostic imaging
Ventilation
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Summary:Our goal was to investigate the effects of head-thorax elevation (HUP) during chest compressions (CC) on lung ventilation. A prospective study was performed on seven human cadavers. Chest was automatically compressed-decompressed in flat position and during progressive HUP from 18 to 35°. Lung ventilation was measured with electrical impedance tomography. In each cadaver, 5 sequences were randomly performed: one without CC at positive end-expiratory pressure (PEEP) 0cmH 2 O, 3 s with CC at PEEP0, 5 or 10cmH 2 O and 1 with CC and an impedance threshold device at PEEP0cmH 2 O. The minimal-to-maximal change in impedance (VT EIT in arbitrary unit a.u.) and the minimal impedance in every breathing cycle (EELI) the) were compared between flat, 18°, and 35° in each sequence by a mixed-effects model. Values are expressed as median (1st–3rd quartiles). With CC, between flat, 18° and 35° VT EIT decreased at each level of PEEP. It was 12416a.u. (10,689; 14,442), 11,239 (7667; 13,292), and 6457 (4631; 9516), respectively, at PEEP0. The same was true with the impedance threshold device. EELI/VT EIT significantly decreased from − 0.30 (− 0.40; − 0.15) before to − 1.13 (− 1.70; − 0.61) after the CC (P = 0.009). With HUP lung ventilation decreased with CC as compared to flat position. CC are associated with decreased in EELI.
ISSN:2045-2322
2045-2322
DOI:10.1038/s41598-023-47727-z