THE INCIDENCE OF REGURGITATION DURING CARDIOPULMONARY-RESUSCITATION -A COMPARISON BETWEEN THE BAG VALVE MASK AND LARYNGEAL MASK AIRWAY

The risk of gastric regurgitation and subsequent pulmonary aspiration is a recognised complication of cardiac arrest-a risk which may be fur ther increased by the resuscitative procedure itself. The purpose of t his study was to compare the incidence of gastric regurgitation betwee n the bag valve mask (BVM) and laryngeal mask airway (LMA). The resusc itation data collection forms of 996 patients who underwent in-hospita l cardiopulmonary resuscitation over a 3.5 year period were reviewed. Of these, 199 patients were excluded from the study because there was no airway management involving a BVM or LMA. The incidence and timing of regurgitation was studied in the remaining 797 patients. Regurgitat ion was recorded to have occurred at some stage in 180 of these patien ts (22.6%). However, 84 regurgitated prior to CPR (46.7% of those pati ents who regurgitated). These patients were excluded from further anal ysis as regurgitation could not have been affected by any form of vent ilation. Of the remaining 713 patients, BVM ventilation was used in 63 6 cases. In 170 of these the LMA was also used following the BVM. Wher e the patient was ventilated with the BVM alone or BVM followed by ETT the incidence of regurgitation during CPR was 12.4%. The LMA was used during resuscitation in 256 cases of which 170 had BVM ventilation pr ior to the LMA. Where the patient was ventilated with the LMA alone or LMA followed by ETT the incidence of regurgitation during CPR was 3.5 %. The study confirms experience reported in earlier studies that when an LMA is used as a first line airway device, regurgitation is relati vely uncommon. (C) 1998 Elsevier Science Ireland Ltd. All rights reser ved.