Chest ACCP Member Benefits
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

Guest Access | Sign In via User Name/Password
This Article
Right arrow Full Text Free
Right arrow Full Text (PDF) Free
Right arrow Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in ISI Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Article Archive
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via ISI Web of Science (4)
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Ayoub, I. M.
Right arrow Articles by Gazmuri, R. J.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Ayoub, I. M.
Right arrow Articles by Gazmuri, R. J.
(Chest. 2001;120:1663-1670.)
© 2001 American College of Chest Physicians

Transtracheal Oxygenation*

An Alternative to Endotracheal Intubation During Cardiac Arrest

Iyad M. Ayoub, MS; Derek J. Brown, BA and Raúl J. Gazmuri, MD, PhD

* From the Medical Service, Section of Critical Care Medicine, North Chicago VA Medical Center and Department of Medicine, Division of Critical Care Medicine, Finch University of Health Sciences/The Chicago Medical School, North Chicago, IL.

Correspondence to: Raúl J. Gazmuri, MD, PhD, Medical Service (111), North Chicago VA Medical Center, 3001 Green Bay Rd, North Chicago, IL, 60064; e-mail: Raul.Gazmuri{at}med.va.gov

Study objectives: Because efforts to secure adequate arterial oxygenation during cardiac resuscitation are more important than efforts to promote CO2 elimination, we investigated whether continuous transtracheal oxygenation (TTO) could represent a potentially simpler alternative to conventional positive-pressure ventilation with 100% O2 through an endotracheal tube.

Design: Controlled and randomized.

Setting: Animal laboratory.

Participants: Thirty male Sprague-Dawley rats.

Interventions: The technique for TTO was initially developed and tested in five rats. A model of ventricular fibrillation (VF) was then used to compare the effects of TTO (n = 5) with the effects of O2 delivery through an endotracheal tube as part of positive-pressure ventilation (n = 5) or through a mask without additional airway intervention (n = 5). VF was induced and left untreated for 4 min, after which chest compression and one of the three oxygenation interventions was started. Defibrillation was attempted after 6 min of chest compression. In a subsequent series, defibrillation was attempted after 10 min of chest compression in rats treated with either TTO (n = 5) or endotracheal intubation (ET; n = 5).

Measurement and results: TTO and ET secured adequate arterial PO2 during chest compression (213 ± 77 mm Hg and 154 ± 36 mm Hg; not significant), whereas the mask yielded an arterial PO2 of only 49 ± 38 mm Hg (p < 0.05). Each rat treated with TTO or ET was successfully resuscitated and survived the postresuscitation interval, but none of the rats treated with the mask survived. TTO maintained its efficacy after increased duration of chest compression.

Conclusion: TTO was as effective as conventional positive-pressure ventilation with 100% O2 for securing oxygenation, resuscitation, and short-term survival and more effective than O2 delivered through a mask.

Key Words: cardiopulmonary resuscitation • intubation, intratracheal • O2 • rats, Sprague-Dawley • trachea • ventricular fibrillation






HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Copyright © 2001 by the American College of Chest Physicians.