In the current guidelines on cardiopulmonary resuscitation appriccio the cardiac arrest is to provide circulatory support and support ventilation with a ratio of 30 chest compressions to 2 insuflazioni. This approach is also called CPR, Cardiopulmonary Resuscitation.
But all this could change in the new revision of the guidelines in 2015 by switching to a CCO approach, Chest Compression Only. Then we stop to give oxygen to our patients in cardiopulmonary arrest? For now do not know, but we see the rationale of why a possible choice.
The evidence is this retrospective study of 2012 published in Circulation entitled " Chest Compression Alone Cardiopulmonary Resuscitation Is Associated With Better Long-Term Survival Compared with Standard Cardiopulmonary Resuscitation "that compared the survival of 1210 patients treated with an approach toward 1253 CCO treated CPR with the "classic".
The result, against all expectations, was that survival is much higher in patients treated with only chest compressions compared to those treated with the current approach 30: 2. Why? Perhaps this means that actually in the patient in cardiac arrest are much more important chest compressions quality and that the smallest interruption to compressions produces a dramatic fall intravascular pressure created by the previous cycle, and then, in the next, big part of compressions are lost in recreating this pressure.
Another point in favor of the sun chest compressions with the fact, often asserted, that already the only chest compressions, going to compress the chest, producing, in addition to the desired compression of the heart muscle also an effective compression of the lungs by producing so, to each compression, a breathing "passive" of the patient. However, a 2010 study, always in Circulation entitled " Validating Effectiveness of Ventilation Generated by Chest Compression Alone in the Model Lung "says instead that the volumes of air created during the CCO alone are not sufficient to provide minimal support functions the basis of the patient.
Where we go from here then in the next 5 years of BLSD? We'll know soon.