A reappraisal of mouth-to-mouth ventilation during bystander-initiated cardiopulmonary resuscitation. A Statement for Healthcare Professionals From the Ventilation Working Group of the Basic Life Support and Pediatric Life Support Subcommittees, American Heart Association

Resuscitation

Volumn 35, Issue 3, 1997, Pages 189-201

  Becker, Lance B ^a   Berg, Robert A ^a   Pepe, Paul E ^a   Idris, Ahamed H ^a   Aufderheide, Thomas P ^a   Barnes, Thomas A ^a   Stratton, Samuel J ^a   Chandra, Nisha C ^a  

^a NONE

Author keywords

Cardiopulmonary resuscitation; Sudden death; Ventilation

Indexed keywords

ARTIFICIAL VENTILATION; HUMAN; PRIORITY JOURNAL; RESUSCITATION; REVIEW; SUDDEN DEATH;

EID: 0031469047     PISSN: 03009572     EISSN: None     Source Type: Journal    
DOI: 10.1016/S0300-9572(97)00073-7     Document Type: Article

References (121)

1. American Heart Association. Guidelines for cardiopulmonary resuscitation and emergency cardiac care. J Am Med Assoc 1992;268:2171-83.
2. Cummins RO, Eisenberg MS. Prehospital cardiopulmonary resuscitation: is it effective?. J Am Med Assoc 1985;253:2408-12.
3. Lombardi G, Gallagher J, Gennis P. Outcome of out-of-hospital cardiac arrest in New York City: the Pre-Hospital Arrest Survival Evaluation (PHASE) Study. J Am Med Assoc 1994;271:678-83.
4. Eisenberg MS, Horwood BT, Cummins RO, Reynolds-Haertle R, Hearne TC. Cardiac arrest and resuscitation: a tale of 29 cities. Ann Emerg Med 1990;19:179-86.
5. Becker LB, Ostrander MP, Barrett J, Kondos GJ. Outcome of CPR in a large metropolitan area: where are the survivors?. Ann Emerg Med 1991;20:355-61.
6. Schindler MB, Bohn D, Cox PN, et al. Outcome of out-of-hospital cardiac or respiratory arrest in children. New Engl J Med 1996;335:1473-9.
7. Brenner BE, Kauffman J. Reluctance of internists and medical nurses to perform mouth-to-mouth resuscitation. Arch Intern Med 1993;153:1763-9.
8. Brenner B, Stark B, Kauffman J. The reluctance of house staff to perform mouth-to-mouth resuscitation in the inpatient setting: what are the considerations?. Resuscitation 1994;28:185-93.
9. Brenner B, Kauffman J, Sachter JJ. Comparison of the reluctance of house staff of metropolitan and suburban hospitals to perform mouth-to-mouth resuscitation. Resuscitation 1996;32:5-12.
10. McCormack AP, Damon SK, Eisenberg MS. Disagreeable physical characteristics affecting bystander CPR. Ann Emerg Med 1989;18:283-5.
11. Michael AD, Forrester JS. Mouth-to-mouth ventilation: the dying art. Am J Emerg Med 1992;10:156-61.
12. Locke CJ, Berg RA, Sanders AB, et al. Bystander cardiopulmonary resuscitation: concerns about mouth-to-mouth contact. Arch Intern Med 1995;155:938-43.
13. Ornato JP, Hallagan LF, McMahan SB, Peeples EH, Rostafinski AG. Attitudes of BCLS instructors about mouth-to-mouth resuscitation during the AIDS epidemic. Ann Emerg Med 1990;19:151-6.
14. Melker RJ, Banner MJ. Ventilation during CPR: two-rescuer standards reappraised. Ann Emerg Med 1985;14:397-402.
15. Ruben H, Knudsen EJ, Carugti G. Gastric insufflation in relation to airway pressure. Acta Anaesthesiol Scand 1961;5:107-14.
16. Ruben R, Ruben H. Artificial respiration: flow of water from the lung and the stomach. Lancet 1962;1:780-1.
17. Ruben H. The immediate treatment of respiratory failure. Br J Anaesth 1964;36:542-9.
18. Flesche CW, Noetges P, Schlack W, Zucker TP, Tarnow J. Quality of lay public cardiopulmonary resuscitation after standard first aid training courses. Resuscitation 1994;28:S25. Abstract.
19. Wenzel V, Idris AH, Banner MJ, Fuerst RS, Tucker KJ. The composition of gas given by mouth-to-mouth ventilation during CPR. Chest 1994;106:1806-10.
20. Wenzel V, Lehmkuhl P, Kubilis PS, Idris AH, Pichlmayr I. Poor correlation of mouth-to-mouth ventilation skills after basic life support training and 6 months later. Resuscitation 1997; 35 129-134.
21. Bartecchi CE. Cardiopulmonary resuscitation: an element of sophistication in the 18th century. Am Heart J 1980;100:580-1.
22. DeBard ML. The history of cardiopulmonary resuscitation. Ann Emerg Med 1980;9:273-5.
23. Hermreck AS. The history of cardiopulmonary resuscitation. Am J Surg 1988;156:430-6.
24. Gordon A, Fainer D, Ivy A. Artificial respiration: a new method and a comparative study of different methods in adults. J Am Med Assoc 1950;144:1455-64.
25. Karpovich PV. Adventures in Artificial Respiration. New York: Association Press, 1953.
26. Safar P, Escarraga LA, Chang F. Upper airway obstruction in the unconscious patient. Appl Physiol 1959;14:760-4.
27. Elam JO, Brown ES, Elder JJD. Artificial respiration by mouth-to-mask method: a study of the respiratory gas exchange of paralyzed patient ventilated by operator's expired air. New Engl J Med 1954;250:749-54.
28. Guildner CW. Resuscitation - opening the airway: a comparative study of techniques for opening the airway obstructed by the tongue. J Am Coll Emerg Phys 1976;5:588-90.
29. Safar P. Ventilatory efficacy of mouth to mouth artificial respiration: airway obstruction during manual and mouth to mouth artificial respiration. J Am Med Assoc 1958;167:335-41.
30. Safar P, Escarraga LA, Elam JO. Comparison of mouth-to-mouth and mouth-to-airway methods of artificial respiration with the chest-pressure arm-lift methods. New Engl J Med 1958;58:671-7.
31. Safar P, Brown TC, Holtey WJ, Wilder RJ. Ventilation and circulation with closed-chest cardiac massage in man. J Am Med Assoc 1961;176:574-6.
32. Dill DB. Symposium of mouth-to-mouth resuscitation (expired air inflation). Council on Medical Physics. J Am Med Assoc 1958;167:317-9.
33. Kouwenhoven WB, Jude JR, Knickerbocker GG. Closed-chest cardiac massage. J Am Med Assoc 1960;173:94-7.
34. Cardiopulmonary Resuscitation Committee on CPR of the Division of Medical Sciences, National Academy of Sciences-National Research Council. J Am Med Assoc 1966;198:138-145, 372-9.
35. Haffis LC, Kirimli B, Safar P. Ventilation-cardiac compression rates and ratios in cardiopulmonary resuscitation. Anesthesiology 1967;28:806-13.
36. Cummins RO, Eisenberg MS, Hallstrom AD, Litwin PE. Survival of out-of-hospital cardiac arrest with early initiation of cardiopulmonary resuscitation. Am J Emerg Med 1985;3:114-9.
37. Bossaert L, Van Hoeyweghen R. Cerebral Resuscitation Study Group, Evaluation of cardiopulmonary resuscitation (CPR) techniques. Resuscitation 1989;17:S199-206.
38. Van Hoeyweghen RJ, Bossaert LL, Mullie A, et al. Quality and efficiency of bystander CPR. Resuscitation 1993;26:47-52.
39. Bossaert L, Vanhoeyweghen R. Belgian Cerebral Resuscitation Study Group, Bystanders cardiopulmonary resuscitation (CPR) in out-of-hospital cardiac arrest. Resuscitation 1989;17(1):S55-69.
40. Weisfeldt ML, Kerber RE, McGoldrick RP, et al. American Heart Association report on the Public Access Defibrillation Conference, December 8-10, 1994, Automatic External Defibrillation Task Force. Circulation 1995;92:2740-7.
41. Weisfeldt ML, Kerber RE, McGoldrick RP, et al. Public access defibrillation: a statement for healthcare professionals from the American Heart Association Task Force on Automatic External Defibrillation. Circulation 1995;92:2763.
42. Eisenberg MS, Bergner L, Hallstrom A. Cardiac resuscitation in the community: importance of rapid provision and implications for program planning. J Am Med Assoc 1979;241:1905-7.
43. Larsen MP, Eisenberg MS, Cummins RO, Hallstrom AP. Predicting survival from out-of-hospital cardiac arrest: a graphic model. Ann Emerg Med 1993;22:1652-8.
44. Valenzuela T, Roe DJ, Kretins S, Sparte DW, Larsen MP. Estimating cardiac arrest interventions: a logistics regression survival model. Circulation 1997 (In press).
45. Redding JS, Pearson JW. Evaluation of drugs for cardiac resuscitation. Anesthesiology 1963;24:203-7.
46. Pearson JW, Redding JS. Influence of peripheral vascular tone on cardiac resuscitation. Anesth Analg 1965;44:746-52.
47. Ralston SH, Tacker WA, Showen L, Carter A, Babbs CF. Endotracheal versus intravenous epinephrine during electromechanical dissociation with CPR in dogs. Ann Emerg Med 1985;14:1044-8.
48. Michael JR, Guerci AD, Koehler RC, et al. Mechanisms by which epinephrine augments cerebral and myocardial perfusion during cardiopulmonary resuscitation in dogs. Circulation 1984;69:822-35.
49. Sanders AB, Ewy GA, Taft TV. Prognostic and therapeutic importance of the aortic diastolic pressure in resuscitation from cardiac arrest. Crit Care Med 1984;12:871-3.
50. Sanders AB, Kern KB, Atlas M, Bragg S, Ewy GA. Importance of the duration of inadequate coronary perfusion pressure on resuscitation from cardiac arrest. J Am Coll Cardiol 1985;6:113-8.
51. Sanders AB, Kern KB, Bragg S, Ewy GA. Neurologic benefits from the use of early cardiopulmonary resuscitation. Ann Emerg Med 1987;16:142-6.
52. Kern KB, Ewy GA, Voorhees WD, Babbs CF, Tacker WA. Myocardial perfusion pressure: a predictor of 24-h survival during prolonged cardiac arrest in dogs. Resuscitation 1988;16:241-50.
53. Berg RA, Otto CW, Kern KB, et al. High-dose epinephrine results in greater early mortality after resuscitation from prolonged cardiac arrest in pigs: a prospective randomized study. Crit Care Med 1994;22:282-90.
54. Paradis NA, Martin GB, Rivers EP, et al. Coronary perfusion pressure and return of spontaneous circulation in human cardiopulmonary resuscitation. J Am Med Assoc 1990;263:1106-13.
55. Eisenberg MS, Copass MK, Hallstrom AP, et al. Treatment of out-of-hospital cardiac arrests with rapid defibrillation by emergency medical technicians. New Engl J Med 1980;302:1379-83.
56. Adgey AA, Scott ME, Allen JD, Nelson PG, Geddes JS, Zaidi SA. Management of ventricular fibrillation outside hospital. Lancet 1969;1:1169-71.
57. Weaver WD, Copass MK, Bufi D, Ray R, Hallstrom AP, Cobb LA. Improved neurologic recovery and survival after early defibrillation. Circulation 1984;69:943-8.
58. Weaver WD, Cobb LA, Hallstrom AP, Fahrenbruch C, Copass MK, Ray R. Factors influencing survival after out-of-hospital cardiac arrest. J Am Coll Cardiol 1986;7:752-7.
59. Copley DP, Mantle JA, Rogers WJ, Russell RO Jr., Rackley CE. Improved outcome for prehospital cardiopulmonary collapse with resuscitation by bystanders. Circulation 1977;56:901-5.
60. Becker LB, Han BH, Meyer PM, et al. CPR Chicago Project. Racial differences in the incidence of cardiac arrest and subsequent survival. New Engl J Med 1993;329:600-6.
61. Kyriacou DN, Arcinue EL, Peek C, Kraus JF. Effect of immediate resuscitation on children with submersion injury. Pediatrics 1994;94:137-42.
62. Fuerst R, Idris A, Banner M, Wenzel V, Orban D. Changes in respiratory system compliance during cardiopulmonary arrest with and without closed chest compressions. Ann Emerg Med 1993;22:931.
63. Pepe PE. Acute respiratory insufficiency. In: Hardwood-Nuss A, Linden CH, Luten RC, Shepherd SM, Wolfson AB, editors. The Clinical Practice of Emergency Medicine. Philadelphia, Pa: JB Lippincott, 1996:636-640.
64. Pepe PE, Zachariah BS, Chandra NC. Invasive airway techniques in resuscitation. Ann Emerg Med 1993;22(2):393-403.
65. Pepe PE, Copass MK, Joyce TH. Prehospital endotracheal intubation: rationale for training emergency medical personnel. Ann Emerg Med 1985;14:1085-92.
66. Johnson BA, Weil MH, Tang W, Noc M, McKee D, McCandless D. Mechanism of myocardial hypercarbic acidosis during cardiac arrest. Am J Physiol 1995;78:1579-84.
67. Kette F, Weil MH, Gazmuri RJ, Bisera J, Rackow ER. Intramyocardial hypercarbic acidosis during cardiac arrest and resuscitation. Crit Care Med 1993;21:901-6.
68. Tucker KJ, Idris AH, Wenzel V, Orban DJ. Changes in arterial and mixed venous blood gases during untreated ventricular fibrillation and cardiopulmonary resuscitation. Resuscitation 1994;28:137-41.
69. Idris AH, Staples ED, O'Brien DJ, et al. Effect of ventilation on acid-base balance and oxygenation in low blood-flow states. Crit Care Med 1994;22:1827-34.
70. Chandra NC, Gruben KG, Tsitlik JE, et al. Observations of ventilation during resuscitation in a canine model. Circulation 1994;90:3070-5.
71. Idris AH, Banner MJ, Wenzel V, Fuerst RS, Becker LB, Melker RJ. Ventilation caused by external chest compression is unable to sustain effective gas exchange during CPR: a comparison with mechanical ventilation. Resuscitation 1994;28:143-50.
72. Idris AH, Wenzel V, Tucker KJ, Orban DJ. Chest compression ventilation: a comparison of standard CPR and active-compression/decompression CPR. Acad Emerg Med 1994;1:A1-7.
73. Idris AH. Reassessing the need for ventilation during CPR. Ann Emerg Med 1996;27:569-75.
74. Noc M, Weil MH, Tang W, Turner T, Fukui M. Mechanical ventilation may not be essential for initial cardiopulmonary resuscitation. Chest 1995;108:821-7.
75. Berg RA, Wilcoxson D, Hilwig RW, et al. The need for ventilatory support during bystander CPR. Ann Emerg Med 1995;26:342-50.
76. Berg RA, Kern KB, Hilwig RW, et al. Assisted ventilation does not improve outcome in a porcine model of single-rescuer bystander cardiopulmonary resuscitation. Circulation 1997;95:1635-41.
77. Tang W, Weil MH, Sun S, et al. Cardiopulmonary resuscitation by precordial compression but without mechanical ventilation. Am J Respir Crit Care Med 1994;150:1709-13.
78. Noc M, Weil MH, Sun S, Tang W, Bisera J. Spontaneous gasping during cardiopulmonary resuscitation without mechanical ventilation. Am J Respir Crit Care Med 1994;150:861-4.
79. Yang L, Weil MH, Noc M, Tang W, Turner T, Gazmuri RJ. Spontaneous gasping increases the ability to resuscitate during experimental cardiopulmonary resuscitation. Crit Care Med 1994;22:879-83.
80. Meursing BTJ, Zimmerman ANE, Van Heyst ANP. Experimental evidence in favor of a reversed sequence in cardiopulmonary resuscitation. J Am Coll Cardiol 1983;1:610. Abstract.
81. Simoons ML, Kimman GP, Ivens EMA, Hartman JAM, Hart HN. Follow up after out of hospital resuscitation. Read before the XIIth Annual Congress of the European Society of Cardiology; September 16-20, 1990; Stockholm, Sweden.
82. Berg RA, Kern KB, Sanders AB, Otto CW, Hilwig RW, Ewy GA. Bystander cardiopulmonary resuscitation: is ventilation necessary?. Circulation 1993;88(1):1907-15.
83. Idris AH, Becker LB, Fuerst RS, et al. Effect of ventilation on resuscitation in an animal model of cardiac arrest. Circulation 1994;90:3063-9.
84. Idris AH, Wenzel V, Becker LB, Banner MJ, Orban DJ. Does hypoxia or hypercarbic acidosis independently affect survival from cardiac arrest?. Chest 1995;108:522-8.
85. Clark JJ, Larsen MP, Culley LL, Graves JR, Eisenberg MS. Incidence of agonal respirations in sudden cardiac arrest. Ann Emerg Med 1992;21:1464-7.
86. Weil MH, Sun S, Bisera J, Tang W, Gazmuri RJ. Challenge of the ABC's of cardiopulmonary resuscitation. Chest 1994;102:1275.
87. Cohen TJ, Tucker KJ, Lurie KG, et al. Active compression-decompression: a new method of cardiopulmonary resuscitation. J Am Med Assoc 1992;267:2916-23.
88. Idris AH, Wenzel V, Banner MJ, Melker RJ. Smaller tidal volumes minimize gastric inflation during CPR with an unprotected airway. Circulation 1992;92(1):759-60. Abstract.
89. Johannigman JA, Branson RD, Davis K Jr., Hurst JM. Techniques of emergency ventilation: a model to evaluate tidal volume, airway pressure, and gastric insufflation. J Trauma 1991;31:93-8.
90. Cohen S. Pathogenesis of coffee-induced gastrointestinal symptoms. New Engl J Med 1980;303:122-4.
91. Fisher RS, Malmud LS, Lobis IF, Maier WP. Antireflux surgery for symptomatic gastroesophageal reflux: mechanism of action. Am J Dig Dis 1978;23:152-60.
92. Bowman FP, Menagazzi JJ, Check BD, Duckett TM. Lower esophageal sphincter pressure during prolonged cardiac arrest and resuscitation. Ann Emerg Med 1995;26:216-9.
93. Sellick BA. Cricoid pressure to control regurgitation of stomach contents during induction of anesthesia. Lancet 1961;2:404-6.
94. Rottenberg EM, Dzwonczyk R, Reilley TE, Malone M. Use of supplemental oxygen during bystander-initiated CPR. Ann Emerg Med 1994;23:1027-31.
95. Idris AH, Wenzel V, Kubilis PS, Rush WJ, Band RA, Williams JL Jr. Mouth to mouth ventilation decreases the rate of successful cardiopulmonary resuscitation in an animal model of cardiac arrest. Chest 1997 (In press).
96. Walley KR, Ford LE, Wood LD. Effects of hypoxia and hypercapnia on the force-velocity relation of rabbit myocardium. Circ Res 1991;69:1616-25.
97. Hongo K, White E, Orchard CH. The effect of mechanical loading on the response of rat ventricular myocytes to acidosis. Exp Physiol 1995;80:701-12.
98. Halperin HR, Tsitlik JE, Guerci AD, et al. Determinants of blood flow to vital organs during cardiopulmonary resuscitation in dogs. Circulation 1986;73:539-50.
99. Feneley MP, Maier GW, Kern KB, et al. Influence of compression rate on initial success of resuscitation and 24-h survival after prolonged manual cardiopulmonary resuscitation in dogs. Circulation 1988;77:240-50.
100. Kern KB, Sanders AB, Raife J, Milander MM, Otto CW, Ewy GA. A study of chest compression rates during CPR in humans: the importance of rate directed chest compressions. Arch Intern Med 1992;152:145-9.
101. Thomas AN, Weber EC. A new method of two-resuscitator CPR. Resuscitation 1993;26:173-6.
102. Hightower D, Thomas SH, Stone CK, Dunn K, March JA. Decay in quality of closed-chest compressions over time. Ann Emerg Med 1995;26:300-3.
103. Milander MM, Hiscok PS, Sanders AB, Kern KB, Berg RA, Ewy GA. Chest compression and ventilation rates during cardiopulmonary resuscitation: the effects of audible tone guidance. Acad Emerg Med 1995;2:708-13.
104. Figura N. Mouth-to-mouth resuscitation and Helicobacter pylori infection. Lancet 1996;347:1342. Letter.
105. Heilman KM, Muscheheim C. Primary cutaneous tuberculosis resulting from mouth-to-mouth respiration. New Engl J Med 1965;273:1035-6.
106. Feldman HA. Some recollections of the meningococcal disease: the first Harry F. Dowling lecture. J Am Med Assoc 1972;220:1107-12.
107. Finkelhor RS, Lampman JH. Herpes simplex infection following mouth-to-mouth resuscitation. J Am Med Assoc 1980;243:650. Letter.
108. Mannis MJ, Wendel RT. Transmission of herpes simplex during cardiopulmonary resuscitation training. Comp Ther 1984;10:15-7.
109. Hendricks AA, Shapiro EP. Primary herpes simplex infection following mouth-to-mouth resuscitation. J Am Med Assoc 1980;243:257-8.
110. Todd MA, Bell JS. Shigellosis from cardiopulmonary resuscitation. J Am Med Assoc 1980;243:331. Letter.
111. Valenzuela TD, Hooten TM, Kaplan EL, Schlievert P. Transmission of 'toxic strep' syndrome from an infected child to a firefighter during CPR. Ann Emerg Med 1991;20:90-2.
112. Ahmad F, Senadhira DC, Charters J, Acquilla S. Transmission of salmonella via mouth-to-mouth resuscitation. Lancet 1990;335:787-8. Letter.
113. Lawrence PJ, Sivaneswaran N. Ventilation during cardiopulmonary resuscitation: which method?. Med J Aust 1985;143:443-6.
114. Braslow A, Brennan RT, Newman MM, Bircher NG, Batcheller AM, Kaye W. CPR training without an instructor: development and evaluation of a video self-instructional system for effective performance of cardiopulmonary resuscitation. Resuscitation 1997;34:207-20.
115. Hickey RW, Cohen DM, Strausbaugh S, Dietrich AM. Pediatrie patients requiring CPR in the prehospital setting. Ann Emerg Med 1995;25:495-501.
116. Mogayzel C, Quan L, Graves JR, Tiedeman D, Fahrenbruch C, Herndon P. Out-of-hospital ventricular fibrillation in children and adolescents: causes and outcomes. Ann Emerg Med 1995;25:484-91.
117. Whitelaw CC, Goldsmith LJ. Comparison of two techniques for determining the presence of a pulse in an infant. Acad Emerg Med 1997;4:153-4. Letter.
118. Paradis NA, Martin GB, Goetting MG, Rivers EP, Feingold M, Nowak RM. Aortic pressure during human cardiac arrest: identification of human pseudo-electromechanical dissociation. Chest 1992;101:123-8.
119. Lee CS, Bullock LJ. Determining the pulse for infant CPR: time for a change?. Mil Med 1991;156:190-3.
120. Cavallaro DL, Melker RJ. Comparison of two techniques for detecting cardiac activity in infants. Crit Care Med 1983;11:189-90.
121. Hazinski MF. Is pediatric resuscitation unique? Relative merits of early CPR and ventilation versus early defibrillation for young victims of prehospital cardiac arrest. Ann Emerg Med 1995;25:540-3.