Modification of the closed circuit underwater breathing apparatus LAR V makes it suitable for cardiopulmonary resuscitation (CPR)

Abstract

This pilot study was carried out in order to determine whether or not a modified closed circuit underwater oxygen rebreathing device could serve as an adjunct for ventilation during CPR in remote locations. As a control a common self-inflating bag valve ventilation device was used. Methods: A total of 20 combat divers were enrolled, of whom 18 met the criteria to be included in two-rescuer CPR manikin training. A modified LAR V (Dräger, Germany), a closed circuit underwater breathing apparatus, that uses pure oxygen, and a conventional Ambu® Mark III bag were used for artificial mask-ventilation in a randomised crossover design. A total of ten cycles of CPR were analysed. Results: Of the divers, 17 were able to ventilate with the modified LAR V. The median tidal volumes were lower with LAR V versus Ambu® (725 vs 800 ml; P=0.04) and median total time required was significantly longer with LAR V versus Ambu® (90 vs 68.5 s; P=0.004). Gastric inflation was associated only with the Ambu®. Conclusions: This modification of the LAR V makes it suitable for CPR performed by military divers when conventional ventilatory devices are not available. It would be necessary, however, to teach the proper use of the modified ventilation mode and to provide repeated training.