The Effects of Ventilation During Cardiopulmonary Resuscitation Using Manual Bag-Valve or Mechanical Ventilator on the Return of Spontaneous Circulation and Lactate Levels

Aim: The aim is to investigate the effect of manual ventilation using a bag-valve versus mechanical ventilation on the return of spontaneous circulation and the progression of lactate levels during cardiopulmonary resuscitation. Materials and Methods: The study was conducted at the Emergency Medicine Department of Fatih Sultan Mehmet Training and Research Hospital, between January 4, 2019, and January 4, 2021, following ethical approval. It was designed as a prospective, randomized study. Advanced cardiac life support was administered to patients who presented with cardiac arrest. The patients were randomized into two groups, with 15 patients included in each group. The resuscitation team provided manual ventilation with a bag-valve for one group and mechanical ventilation in ‘CPR mode’ for the other group. Lactate levels at 0, 5, 10, 15, and 20 minutes during the intervention, as well as the duration of return of spontaneous circulation, if achieved, were recorded and compared between the groups. Results: The mean age of the patients was 47.8, with 16 male and 14 female patients. CPR was applied for a minimum of 20 minutes. Return of spontaneous circulation (ROSC) was achieved in 4 patients. Lactate levels showed a decrease in the mechanical ventilator group, while an increasing trend was observed in the bag-valve manual ventilation group. There was no significant difference between the groups regarding the effect of the ventilation method on the return of spontaneous circulation (p > 0.05). Conclusion: It was observed that the use of a mechanical ventilator instead of manual bag-valve ventilation did not negatively affect the return of spontaneous circulation. Furthermore, a tendency for lactate levels to decrease was noted in the mechanical ventilation group compared to the bag-valve manual ventilation group.