Novel Pharyngeal Oxygen Delivery Device Provides Superior Oxygenation during Simulated Cardiopulmonary Resuscitation.

Abstract

Introduction: Passive oxygenation with non-rebreather face mask (NRFM) has been used during cardiac arrest as an alternative to positive pressure ventilation (PPV) with bag-valve-mask (BVM) to minimize chest compression disruptions. A dual-channel pharyngeal oxygen delivery device (PODD) was created to open obstructed upper airways and provide oxygen at the glottic opening. It was hypothesized for this study that the PODD can deliver oxygen as efficiently as BVM or NRFM and oropharyngeal airway (OPA) in a cardiopulmonary resuscitation (CPR) manikin model.

Methods: Oxygen concentration was measured in test lungs within a resuscitation manikin. These lungs were modified to mimic physiologic volumes, expansion, collapse, and recoil. Automated compressions were administered. Five trials were performed for each of five arms: (1) CPR with 30:2 compression-to-ventilation ratio using BVM with 15 liters per minute (LPM) oxygen; continuous compressions with passive oxygenation using (2) NRFM and OPA with 15 LPM oxygen, (3) PODD with 10 LPM oxygen, (4) PODD with 15 LPM oxygen; and (5) control arm with compressions only.

Results: Mean peak oxygen concentrations were: (1) 30:2 CPR with BVM 49.3% (SD = 2.6%); (2) NRFM 47.7% (SD = 0.2%); (3) PODD with 10 LPM oxygen 52.3% (SD = 0.4%); (4) PODD with 15 LPM oxygen 62.7% (SD = 0.3%); and (5) control 21% (SD = 0%). Oxygen concentrations rose rapidly and remained steady with passive oxygenation, unlike 30:2 CPR with BVM, which rose after each ventilation and decreased until the next ventilation cycle (sawtooth pattern, mean concentration 40% [SD = 3%]).

Conclusions: Continuous compressions and passive oxygenation with the PODD resulted in higher lung oxygen concentrations than NRFM and BVM while minimizing CPR interruptions in a manikin model.