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. 2018 Nov;46(11):4605-4616.
doi: 10.1177/0300060518786916. Epub 2018 Sep 5.

Arterial blood gas changes during cardiac arrest and cardiopulmonary resuscitation combined with passive oxygenation/ventilation: a METI HPS study

Matej Strnad  1   2   3 , Damjan Lešnik  2   3 , Miljenko Križmarić  1   2
Affiliations

Arterial blood gas changes during cardiac arrest and cardiopulmonary resuscitation combined with passive oxygenation/ventilation: a METI HPS study

Matej Strnad et al. J Int Med Res. 2018 Nov.

Abstract

Objective: High-fidelity simulators can simulate physiological responses to medical interventions. The dynamics of the partial arterial pressure of oxygen (PaO2), partial arterial pressure of carbon dioxide (PaCO2), and oxygen pulse saturation (SpO2) during simulated cardiopulmonary resuscitation (CPR) were observed and compared with the results from the literature.

Methods: Three periods of cardiac arrest were simulated using the METI Human Patient Simulator™ (Medical Education Technologies, Inc., Sarasota, FL, USA): cardiac arrest, chest compression-only CPR, and chest compression-only CPR with continuous flow insufflation of oxygen (CFIO).

Results: In the first period, the observed values remained constant. In the second period, PaCO2 started to rise and peaked at 63.5 mmHg. In the CFIO period, PaCO2 slightly fell. PaO2 and SpO2 declined only in the second period, reaching their lowest values of 44 mmHg and 70%, respectively. In the CFIO period, PaO2 began to rise and peaked at 614 mmHg. SpO2 exceeded 94% after 2 minutes of CFIO.

Conclusions: The METI Human Patient Simulator™ accurately simulated the dynamics of changes in PaCO2. Use of this METI oxygenation model has some limitations because the simulated levels of PaO2 and SpO2 during cardiac arrest correlate poorly with the results from published studies.

Keywords: Patient-specific modeling; blood gas analysis; cardiac arrest; cardiopulmonary resuscitation; high-fidelity simulator; pulmonary ventilation.

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Figures

Figure 1.
Figure 1.
Dynamics of changes in PaCO2. Abbreviations: PaCO2, partial arterial pressure of carbon dioxide; mmHg, millimeters of mercury; min, minute; NC, nasal cannula; NRB, nonrebreather facemask.
Figure 2.
Figure 2.
Dynamics of changes in PaO2. Abbreviations: PaO2, partial arterial pressure of oxygen; mmHg, millimeters of mercury; min, minute; NC, nasal cannula; NRB, nonrebreather facemask.
Figure 3.
Figure 3.
Dynamics of changes in SpO2. Abbreviations: SpO2, oxygen pulse saturation; min, minute; NC, nasal cannula; NRB, nonrebreather facemask.
Figure 4.
Figure 4.
Dynamics of changes in MAP. Abbreviations: MAP, mean arterial pressure; mmHg, millimeters of mercury; min, minute; NC, nasal cannula; NRB, nonrebreather facemask.
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