Effect of metronome rates on the quality of bag-mask ventilation during metronome-guided 30:2 cardiopulmonary resuscitation: A randomized simulation study

Abstract

BACKGROUND: Metronome guidance is a feasible and effective feedback technique to improve the quality of cardiopulmonary resuscitation (CPR). The rate of the metronome should be set between 100 to 120 ticks/minute and the speed of ventilation may have crucial effect on the quality of ventilation. We compared three different metronome rates (100, 110, 120 ticks/minute) to investigate its effect on the quality of ventilation during metronome-guided 30:2 CPR.METHODS: This is a prospective, randomized, crossover observational study using a RespiTrainer ○ r . To simulate 30 chest compressions, one investigator counted from 1 to 30 in cadence with the metronome rate (1 count for every 1 tick), and the participant performed 2 consecutive ventilations immediately following the counting of 30. Thirty physicians performed 5 sets of 2 consecutive (total 10) bag-mask ventilations for each metronome rate. Participants were instructed to squeeze the bag over 2 ticks (1.0 to 1.2 seconds depending on the rate of metronome) and defl ate the bag over 2 ticks. The sequence of three different metronome rates was randomized.

A survey of ventilation strategies during cardiopulmonary resuscitation

“…Nearly half of all respondents could not guarantee a ventilation frequency of 10 breaths per minute as required, and most of them had hyperventilation, which is consistent with prior studies. [16,17] What about using a ventilator? At present, there are no recommendations for the best mechanical ventilation strategy during CPR.…”

Characteristics and outcomes of out-of-hospital cardiac arrest in Zhejiang Province

“…This overall survival rate was lower than the previously reported rates in countries with developed EMS systems. [9,10] In the future, we can train more people to perform bystander CPR, and introduce AEDs in ambulances and public places.…”

Metronome Use Positively Affect Cardiopulmonary Resuscitation Parameters: Prospective Observational Multicenter Manikin Study

“…Na et al [16], adopted to the 30:2 compression to ventilation ratio, performed ventilations according to different compression rates (e.g. 100, 110, 120 compressions/min).…”

“…They reported that as the speed of the metronome rhythm increased, the quality of ventilation decreased. In addition, they recommended a chest compression rate of 100/min in case of a respiratory etiology [16].…”

“…Studies investigating the use of a metronome to increase the quality and effectiveness of CPR have also been conducted [5][6][7][8][9][10][11][12][13][14][15][16][17][18].The use of a metronome was shown to be effective in reaching the target compression [6-10, 14, 18] and ventilation rates [5][6][7][8][9][10][11][12][13][14][15][16], and to affect compression depth [6,[8][9][10][12][13][14][15]. However, no definitive conclusions have been reached regarding the effects of metronome use on chest compression and ventilation rates [6][7][8][9][10][11][12][13][14][15][16][17][18].…”