Compromised cardiopulmonary resuscitation quality due to regurgitation during endotracheal intubation: a randomised crossover manikin simulation study
Dublin Core
Title
Compromised cardiopulmonary resuscitation quality due to regurgitation during endotracheal intubation: a randomised crossover manikin simulation study
Subject
Airway management, Cardiopulmonary resuscitation, Manikin, Regurgitation
Description
Background: Regurgitation is a complication common during cardiopulmonary resuscitation (CPR). This manikin
study evaluated the efect of regurgitation during endotracheal intubation on CPR quality.
Methods: An airway-CPR manikin was modifed to regurgitate simulated gastric contents into the oropharynx dur‑
ing chest compression during CPR. In total, 54 emergency medical technician-paramedics were assigned to either
an oropharyngeal regurgitation or clean airway scenario and then switched to the other scenario after fnishing the
frst. The primary outcomes were CPR quality metrics, including chest compression fraction (CCF), chest compression
depth, chest compression rate, and longest interruption time. The secondary outcomes were intubation success rate
and intubation time.
Results: During the frst CPR–intubation sequence, the oropharyngeal regurgitation scenario was associated with a
signifcantly lower CCF (79.6% vs. 85.1%, P<0.001), compression depth (5.2 vs. 5.4 cm, P<0.001), and frst-pass success
rate (35.2% vs. 79.6%, P<0.001) and greater longest interruption duration (4.0 vs. 3.0 s, P<0.001) than the clean airway
scenario. During the second and third sequences, no signifcant diference was observed in the CPR quality metrics
between the two scenarios. In the oropharyngeal regurgitation scenario, successful intubation was independently
and signifcantly associated with compression depth (hazard ratio=0.47, 95% confdence interval, 0.24–0.91), whereas
none of the CPR quality metrics were related to successful intubation in the clean airway scenario.
Conclusion: Regurgitation during endotracheal intubation signifcantly reduces CPR quality.
Trial registration: ClinicalTrials.gov, NCT05278923, March 14, 2022.
study evaluated the efect of regurgitation during endotracheal intubation on CPR quality.
Methods: An airway-CPR manikin was modifed to regurgitate simulated gastric contents into the oropharynx dur‑
ing chest compression during CPR. In total, 54 emergency medical technician-paramedics were assigned to either
an oropharyngeal regurgitation or clean airway scenario and then switched to the other scenario after fnishing the
frst. The primary outcomes were CPR quality metrics, including chest compression fraction (CCF), chest compression
depth, chest compression rate, and longest interruption time. The secondary outcomes were intubation success rate
and intubation time.
Results: During the frst CPR–intubation sequence, the oropharyngeal regurgitation scenario was associated with a
signifcantly lower CCF (79.6% vs. 85.1%, P<0.001), compression depth (5.2 vs. 5.4 cm, P<0.001), and frst-pass success
rate (35.2% vs. 79.6%, P<0.001) and greater longest interruption duration (4.0 vs. 3.0 s, P<0.001) than the clean airway
scenario. During the second and third sequences, no signifcant diference was observed in the CPR quality metrics
between the two scenarios. In the oropharyngeal regurgitation scenario, successful intubation was independently
and signifcantly associated with compression depth (hazard ratio=0.47, 95% confdence interval, 0.24–0.91), whereas
none of the CPR quality metrics were related to successful intubation in the clean airway scenario.
Conclusion: Regurgitation during endotracheal intubation signifcantly reduces CPR quality.
Trial registration: ClinicalTrials.gov, NCT05278923, March 14, 2022.
Creator
Li‑Wei Lin, James DuCanto, Chen‑Yang Hsu, Yung‑Cheng Su, Chi‑Chieh Huang and Shih‑Wen Hung
Publisher
BMC Emergency Medicine
Date
(2022) 22:124
Contributor
Fajar Bagus W
Format
PDF
Language
English
Type
Text
Files
Collection
Citation
Li‑Wei Lin, James DuCanto, Chen‑Yang Hsu, Yung‑Cheng Su, Chi‑Chieh Huang and Shih‑Wen Hung, “Compromised cardiopulmonary resuscitation quality due to regurgitation during endotracheal intubation: a randomised crossover manikin simulation study,” Repository Horizon University Indonesia, accessed January 30, 2025, https://repository.horizon.ac.id/items/show/4129.