Abstract
port (BLS) may be limited by the physical capabilities of rescuers. The other factor that may affect BLS quality is its energy ex-penditure. Therefore, we decided to com-pare the energy expenditure of standard BLS with a compression-ventilation ratio of 30:2 (S-BLS) and compression-only BLS (CO-BLS) and assess the sensation of fatigue and perceived exertion associated with these activities.Methods. We conducted a simulation study on 10 healthy volunteers using a resuscita-tion manikin. Participants were randomly assigned to start with CO-BLS or with S-BLS, in accordance with recent guidelines. Later, every individual provided the other type of BLS. BLS was terminated in the event of exhaustion, impossibility to re-tain high-quality BLS or after 30 minutes of BLS. Energy expenditure was expressed as relative oxygen consumption (VO2/kg) and area under the curve of all VO2/kg measurements during each BLS proce-dure indexed to one minute (AUCVO2/kg min). All participants completed a survey to assess perceived intensity of exertion by Borg, and sensation of general fatigue by visual analogue scale.Results. Maximal VO2/kg (23.16±3.94 vs. 20.17±2.14 ml/kg/min, p=0.049) and AUCVO2/kg min (18.90±3.13 vs. 15.91±2.07 ml/min3; p=0.021) during S-BLS were significantly higher compared to CO-BLS. Conversely, a more intense rate of perceived exertion (16.6±2.0 vs. 13.8±1.2, p=0.001) and sensation of general fatigue (86.5±10.8 vs. 75.0±14.3, p=0.058) were associated with CO-BLS. Neither sensa-tion of general fatigue, nor perceived exer-tion correlated with energy expenditure.Conclusions. Energy expenditure of S-BLS was higher than of CO-BLS in our study, while sensation of fatigue and perceived exertion reflected the opposite association.
Highlights
In the case of recognized out-of-hospital cardiac arrest (OHCA), initiation of early bystander cardiopulmonary resuscitation (CPR) is of major importance
Maximal VO2/kg reached during basic life support (BLS) protocol was significantly higher when performing SBLS than compression-only BLS (CO-BLS)
(14) Shultz et al compared energy expenditure measured by oxygen consumption of standard BLS and active compression-decompression cardiopulmonary resuscitation 5:1 performed for 10 minutes
Summary
In the case of recognized out-of-hospital cardiac arrest (OHCA), initiation of early bystander cardiopulmonary resuscitation (CPR) is of major importance. It should be started immediately and ensure delivery of high-quality chest compressions until arrival of emergency medical services (EMS). [1] Among other factors, the quality and duration of BLS may be limited by the physical capabilities of rescuers In recent guidelines, this topic is described briefly stating that chest compression depth may decrease soon due to rescuer fatigue. [1] evaluation of BLS feasibility in relation to the physical capabilities of providers can be assessed by subjective indicators (sensation of general fatigue, perceived intensity of exertion) and by objective measurement of energy expenditure, expressed as oxygen consumption during exercise. That CO-BLS is associated with higher energy expenditure, and that higher energy expenditure is associated with higher degree of sensation of general fatigue and perceived intensity of exertion
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