Intensive Care Medicine

, Volume 32, Issue 6, pp 843–851

Constant flow insufflation of oxygen as the sole mode of ventilation during out-of-hospital cardiac arrest

  • Catherine Bertrand
  • François Hemery
  • Pierre Carli
  • Patrick Goldstein
  • Catherine Espesson
  • Michel Rüttimann
  • Jean Michel Macher
  • Brigitte Raffy
  • Patrick Fuster
  • François Dolveck
  • Alain Rozenberg
  • Eric Lecarpentier
  • Philippe Duvaldestin
  • Jean-Marie Saissy
  • Georges Boussignac
  • Laurent Brochard
  • Boussignac Study Group
Original

DOI: 10.1007/s00134-006-0137-2

Cite this article as:
Bertrand, C., Hemery, F., Carli, P. et al. Intensive Care Med (2006) 32: 843. doi:10.1007/s00134-006-0137-2

Abstract

Background

Constant flow insufflation of oxygen (CFIO) through a Boussignac multichannel endotracheal tube has been reported to be an efficient ventilatory method during chest massage for cardiac arrest.

Methods

Patients resuscitated for out-of-hospital cardiac arrest were randomly assigned to standard endotracheal intubation and mechanical ventilation (MV; n = 457) or use of CFIO at a flow rate of 15 l/min (n = 487). Continuous chest compressions were similar in the two groups. Pulse oximetry level was recorded every 5 min. Outcome of initial resuscitation, hospital admission, complications, and discharge from the intensive care unit (ICU) were analyzed. The randomization scheme was changed during the study, but the in-depth analysis was performed only on the first cohort of 341 patients with CFIO and 355 with MV, because of randomization problems in the second part.

Results

No difference in outcome was noted regarding return to spontaneous circulation (CFIO 21%, MV 20%), hospital admission (CFIO 17%, MV 16%), or ICU discharge (CFIO 2.4%, MV 2.3%). The level of detectable pulse saturation and the proportion of patients with saturation above 70% were higher with CFIO. Ten patients with MV but only one with CFIO had rib fractures.

Conclusions

CFIO is a simplified alternative to MV, with favorable effects regarding oxygenation and fewer complications, as observed in this group of patients with desperate prognosis.

Keywords

Cardiopulmonary resuscitation Ventilation Orotracheal intubation Continuous positive airway pressure Emergency medicine 

Supplementary material

134_2006_137_MOESM1_ESM.doc (206 kb)
Electronic Supplementary Material (DOC 211kb)

Copyright information

© Springer-Verlag 2006

Authors and Affiliations

  • Catherine Bertrand
    • 1
  • François Hemery
    • 2
  • Pierre Carli
    • 3
  • Patrick Goldstein
    • 4
  • Catherine Espesson
    • 5
  • Michel Rüttimann
    • 6
  • Jean Michel Macher
    • 7
  • Brigitte Raffy
    • 8
  • Patrick Fuster
    • 9
  • François Dolveck
    • 10
  • Alain Rozenberg
    • 3
  • Eric Lecarpentier
    • 1
  • Philippe Duvaldestin
    • 1
  • Jean-Marie Saissy
    • 11
  • Georges Boussignac
    • 1
  • Laurent Brochard
    • 12
  • Boussignac Study Group
    • 1
  1. 1.Department of Anesthesiology and Emergency Medical Service of Creteil, AP-HPHenri Mondor Hospital, Paris 12 UniversityCreteilFrance
  2. 2.Department of Biostatistics, AP-HPHenri Mondor Hospital, Paris 12 University CreteilCreteilFrance
  3. 3.Department of Anesthesiology and Emergency Medical ServiceNecker Hospital, Paris 5 UniversityParisFrance
  4. 4.Department of Anesthesiology and Emergency Medical ServiceUniversity HospitalLilleFrance
  5. 5.Department of Anesthesiology and Emergency Medical ServiceBellevue HospitalSaint EtienneFrance
  6. 6.Brigade des Sapeurs Pompiers de Paris Medical ServiceParisFrance
  7. 7.Emergency Medical ServiceE. Muller HospitalMulhouseFrance
  8. 8.Emergency Mobile Medical ServicePoissy-St. Germain HospitalPoissyFrance
  9. 9.Department of Anesthesiology and Emergency Medical ServiceE. Heriot HospitalLyonFrance
  10. 10.Department of Anesthesiology and Emergency Medical ServiceR. Poincare HospitalGarchesFrance
  11. 11.Department of Anesthesiology and Intensive Care UnitHôpital d'Instruction des Armée BeginSaint MandéFrance
  12. 12.Medical Intensive Care Unit AP-HPHenri Mondor Hospital, Paris 12 University, INSERM U 651CreteilFrance