THE IMPACT OF RESPIRATORY MUSCLE FATIGUE ON THE QUALITY AND EFFICIENCY OF RESCUE ACTION

INTRODUCTION The lifeguard is the person in charge of safety in water environments. After a rescue, it is possible that he has to execute a CPR. The European Resuscitation Council (ERC) as well as theAmerican Heart Association are currently encouraging a quality CPR performance. The lifeguard may be obliged to carry out a CPR during a long period of time as the response of the Emergency Medical Service takes 5–8 min on average and it can even reach 20 min. The normal respiratory muscle effort at maximal swimming intensity requires a significant fraction of cardiac output and causes leg blood flow to fall. The main objective of this paper was to determine respiratory muscle fatigue (RMF) level in swimming with different intensity on quality and efficiency rescu action in the water. MATERIAL AND METHODS The study involved eleven lifeguards male (9) and female (2); age: (24.25±1.5); body height( 176,27±7,88) and body mass (75.81±11,01)form University School of Physical Education, Cracow. Two tests were conducted: the first test involved the execution of 5 min of CPR (rested), and the second one in performing water rescue and subsequent CPR (exhausted) for 5 minutes. The quality of the CPR at rest and at fatigue condition was compared. The recording instrument was the Ambu Defib Trainer W (Wireless).The time and precision of the simulated water rescue was also registered. Two spirometry tests were performed the first test was set before swimming and the second after (exhausted). Maximal respiratory pressures (PImax, PEmax) were evaluated before and directly after swimming in different intensity.The quality of the respiratory muscle fatigue at rest and at fatigue condition was compared. The recording instrument was portable MicroLoop spirometer. RESULTS After e simulated water rescue significantly increase parameters such as: ventilation minute volume rested (3,06±22,10) exhausted (4,23 ±22,10. P < .001); ventilation rate rested (3.60±34.80) exhausted (4,80 ±34.80. P < .001); and stomach inflation rested (2,0±20,47) exhausted (5.80 ±20.47. P < .001). The greatest variation in the results of the respiratory muscle fatigue both before and after swimming with different intensity was observed only in two parameters: maximal ventilation index (MVV) and peak exhaust flow (PEF). CONCLUSIONS The accumulated fatigue during a simulated water rescue performed by lifeguards reduces the quality of compression depth and pause between compressions. The following respiratory parameters were found to have the strongest effect on the swimming: during maximum exercise intensity and FEV 1 (-0.77) rested and FEV 1 (-0.57) exhausted and FVC (-0.79) rested and FVC (-0.70) exhausted.

Abstract 19: Effects of Stomach Inflation on Hemodynamic and Pulmonary Function During Cardiopulmonary Resuscitation in Pigs

Background : Stomach inflation during cardiopulmonary resuscitation (CPR) is frequent. The purpose of this study was to evaluate effects of different levels of stomach inflation on hemodynamic and pulmonary function during CPR in a porcine model. Methods: After 4min of ventricular fibrillation, randomization to 0, 5, or 10L of stomach inflation was performed in 21 piglets. Basic life support CPR was then initiated for 3min, followed by a combination of epinephrine (45mcg/kg) and vasopressin (0.4U/kg) and defibrillation 2min later, and a post resuscitation phase of 30min. Kruskal-Wallis test was used for analysis; results are given as median (range). Results : During basic life support CPR, 0, 5, and 10L stomach inflation resulted in comparable coronary perfusion pressure between groups [10 (2–20), 8 (4–35), and 5 (0 –18) mmHg, respectively]. Increasing (0, 5, and 10L) stomach inflation resulted in significantly (P<.05) decreasing static pulmonary compliance [52 (38 –98), 19 (8 –32), and 12 (7–15) mL/cmH 2 O, respectively], and significantly increasing mean airway pressure during mechanical ventilation [14 (12–15), 26 (20 – 66), and 40 (13– 46) cmH 2 O]. Arterial partial pressure of oxygen was significantly higher with 0L when compared with 5 and 10L stomach inflation, but comparable between 5 and 10L stomach inflation [378 (88–440), 58 (47–113), and 54 (43–126) mmHg, respectively]. Similarly, arterial partial pressure of carbon dioxide was significantly lower with 0L when compared with 5 and 10L of stomach inflation [30 (24–36), 41(34 –51), and 56 (45– 68) mmHg, respectively]. Return of spontaneous circulation rates were comparable between groups [5/7 in 0L, 4/7 in 5L, and 3/7 in 10L stomach inflation]. Conclusion : In this CPR model, increasing levels of stomach inflation had adverse effects on pulmonary, but not on hemodynamic function.