Does the compression to ventilation ratio affect the quality of CPR: a simulation study

Part 5: Adult Basic Life Support

“…205 The mathematical studies (LOE 5) suggested that the optimal compression-ventilation ratio was near 30:2 for healthcare professionals and near 60:2 for lay rescuer 206 or was a function of body weight in children. 207 Other theoretical studies have recommended ratios of 15:2 or 50:5 208 or around 20:1. 209 Many manikin studies (all LOE 5) showed that CPR performance, quality, and rescuer's fatigue were not significantly different with differing compression-ventilation ratios, 204,210 -213 while others showed mixed results among various compression-ventilation ratios from 5:1 to 60:2.…”

Update on cardiopulmonary resuscitation and emergency cardiovascular care guidelines

“…26 Finally, one theoretical analysis of various C:V ratios suggests 30:2 provides the best blood flow and oxygen delivery while a second similar study found continuous compressions to be most effective for the first two minutes of CPR but 15:2 or 50:5 to be best thereafter. 29,34 Since the publication of the 2005 guidelines, the results of one combined animal and manikin study strongly support the hypothesis that a C:V ratio of 30:2 is superior to 15:2. 35 Two human studies of different C:V ratios have also been published since the 2005 guidelines were released.…”

“…27 C:V ratios of 100:0, 100:2, 50:2, 50:5, 30:2, 15:2, 10:1, and 5:1 have received limited study with mixed results. 12,13,22,25,26,[28][29][30][31][32][33] Rescuer fatigue with high rates of continuous compression may be a limiting factor. 30 In a single animal study when the airway was partially obstructed, a ratio of 30:2 was associated with a significantly shorter time to the return of spontaneous circulation (ROSC) and greater systemic and cerebral oxygenation versus continuous chest compressions.…”

Dispositifs automatisés de massage cardiaque externe : l’échec d’un concept

“…Il est aussi démontré que s'il fallait plusieurs compressions thoraciques pour arriver à ce résultat, une interruption de quelques secondes des compressions suffisait pour provoquer une chute de la pression aortique à son niveau de base d'environ 10 mmHg. À la reprise des compressions thoraciques, il faut de nouveau réaliser environ cinq compressions avant d'atteindre les niveaux de pression suffisants pour obtenir une perfusion coronaire et cérébrale [11]. Cela a conduit à privilégier les compressions thoraciques (en particulier aux dépens de la ventilation) au cours de la réanimation cardiopulmonaire.…”