Evaluation of Gas Exchange Capability and Work Requirements of a Hand-Powered Resuscitator for Organophosphate Casualties

摘要

The authors measured pulmonary ventilation and respiratory gas exchange produced by a hand-powered resuscitator (RDIC) and cricothyroid cannula in animals challenged with organophosphate (OP). Dogs weighing 20-25 Kg, anesthetized with sodium pentobarbital, were given 2 LD50 of GD I.V., followed by 1 mg atropine I.V. 8 minutes later. Heart rate, arterial pressure, arterial blood gases, deliverew flow, alveolar and dead space ventilation, airway pressure, upper airway leakage, and power done on the cannula and respiratory system were measured periodically for 1 hr following GD. The RDIC was squeezed with two hands. Three dogs each were tested at 20, 30, and 40 compressions/min, determined by metronome. Arterial PCO2 (PaCO2) increased following GD to peak values between 50 to 70 mm Hg. By 2 minutes after atropine administration, PaCO2 started falling rapidly, and at one hr PaCO2 was <28mm Hg and PaO2> 100 mm hg in all but one dog. To test the RDIC in animals with CO2 production (VCO2) equal to humans, three pigs weighing 155 to 200 lb were ventilated at 30 breaths/minute. PaCO2 after GD and atropine administration was between 40 and 52 mm Hg with VCO2 about 400 ml/min. Keywords: Pulmonary resuscitation, Organophosphate agents, Resuscitator device, Chemical warfare agents.