Hands-only cardiopulmonary resuscitation: is it really dangerous?

In this issue of RESPIRATORY CARE, Lurie and colleagues report a laboratory investigation in which they compared ventilation rates of 10 breaths/min and 2 breaths/min during cardiopulmonary resuscitation (CPR) of swine.1 This is an important hypothesis-generating study regarding cardiopulmonary interactions during CPR. In their model, their data establish that carotid-artery blood flow and brain tissue oxygen tension were lower with the 2-breaths/min strategy than with the 10-breaths/min strategy. However, they make an unsupportable claim based on that physiological observation, that “it is clear that low or no ventilation during CPR can be dangerous and should not be recommended except in circumstances where untrained CPR providers are not willing to perform mouth-to-mouth.”