Physiological effects of providing supplemental air for avalanche victims. A randomised trial
Survival from avalanche burial is dependent on time to extraction, breathing ability, air pocket oxygen content, and avoiding rebreathing of carbon dioxide (CO2). Mortality from asphyxia increases rapidly after burial. Rescue services often arrive too late. Our objective was to evaluate the physiolo...
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| Published in | Resuscitation Vol. 172; pp. 38 - 46 |
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| Main Authors | , , , , , , , , , |
| Format | Journal Article |
| Language | English |
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Elsevier B.V
01.03.2022
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| Abstract | Survival from avalanche burial is dependent on time to extraction, breathing ability, air pocket oxygen content, and avoiding rebreathing of carbon dioxide (CO2). Mortality from asphyxia increases rapidly after burial. Rescue services often arrive too late. Our objective was to evaluate the physiological effects of providing personal air supply in a simulated avalanche scenario as a possible concept to delay asphyxia. We hypothesize that supplemental air toward victim’s face into the air pocket will prolong the window of potential survival.
A prospective randomized crossover experimental field study enrolled 20 healthy subjects in Hemsedal, Norway in March 2019. Subjects underwent in randomized order two sessions (receiving 2 litres per minute of air in front of mouth/nose into the air pocket or no air) in a simulated avalanche scenario with extensive monitoring serving as their own control.
A significant increase comparing Control vs Intervention were documented for minimum and maximum end-tidal CO2 (EtCO2), respiration rate, tidal volume, minute ventilation, heart rate, invasive arterial blood pressures, but lower peripheral and cerebral oximetry. Controls compared to Intervention group subjects had a lower study completion rate (26% vs 74%), and minutes in the air pocket before interruption (13.1 ± 8.1 vs 22.4 ± 5.6 vs), respectively.
Participants subject to simulated avalanche burial can maintain physiologic parameters within normal levels for a significantly longer period if they receive supplemental air in front of their mouth/nose into the air pocket. This may extend the time for potential rescue and lead to increased survival. |
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| AbstractList | Survival from avalanche burial is dependent on time to extraction, breathing ability, air pocket oxygen content, and avoiding rebreathing of carbon dioxide (CO2). Mortality from asphyxia increases rapidly after burial. Rescue services often arrive too late. Our objective was to evaluate the physiological effects of providing personal air supply in a simulated avalanche scenario as a possible concept to delay asphyxia. We hypothesize that supplemental air toward victim’s face into the air pocket will prolong the window of potential survival.
A prospective randomized crossover experimental field study enrolled 20 healthy subjects in Hemsedal, Norway in March 2019. Subjects underwent in randomized order two sessions (receiving 2 litres per minute of air in front of mouth/nose into the air pocket or no air) in a simulated avalanche scenario with extensive monitoring serving as their own control.
A significant increase comparing Control vs Intervention were documented for minimum and maximum end-tidal CO2 (EtCO2), respiration rate, tidal volume, minute ventilation, heart rate, invasive arterial blood pressures, but lower peripheral and cerebral oximetry. Controls compared to Intervention group subjects had a lower study completion rate (26% vs 74%), and minutes in the air pocket before interruption (13.1 ± 8.1 vs 22.4 ± 5.6 vs), respectively.
Participants subject to simulated avalanche burial can maintain physiologic parameters within normal levels for a significantly longer period if they receive supplemental air in front of their mouth/nose into the air pocket. This may extend the time for potential rescue and lead to increased survival. Survival from avalanche burial is dependent on time to extraction, breathing ability, air pocket oxygen content, and avoiding rebreathing of carbon dioxide (CO ). Mortality from asphyxia increases rapidly after burial. Rescue services often arrive too late. Our objective was to evaluate the physiological effects of providing personal air supply in a simulated avalanche scenario as a possible concept to delay asphyxia. We hypothesize that supplemental air toward victim's face into the air pocket will prolong the window of potential survival. A prospective randomized crossover experimental field study enrolled 20 healthy subjects in Hemsedal, Norway in March 2019. Subjects underwent in randomized order two sessions (receiving 2 litres per minute of air in front of mouth/nose into the air pocket or no air) in a simulated avalanche scenario with extensive monitoring serving as their own control. A significant increase comparing Control vs Intervention were documented for minimum and maximum end-tidal CO (EtCO ), respiration rate, tidal volume, minute ventilation, heart rate, invasive arterial blood pressures, but lower peripheral and cerebral oximetry. Controls compared to Intervention group subjects had a lower study completion rate (26% vs 74%), and minutes in the air pocket before interruption (13.1 ± 8.1 vs 22.4 ± 5.6 vs), respectively. Participants subject to simulated avalanche burial can maintain physiologic parameters within normal levels for a significantly longer period if they receive supplemental air in front of their mouth/nose into the air pocket. This may extend the time for potential rescue and lead to increased survival. Survival from avalanche burial is dependent on time to extraction, breathing ability, air pocket oxygen content, and avoiding rebreathing of carbon dioxide (CO2). Mortality from asphyxia increases rapidly after burial. Rescue services often arrive too late. Our objective was to evaluate the physiological effects of providing personal air supply in a simulated avalanche scenario as a possible concept to delay asphyxia. We hypothesize that supplemental air toward victim's face into the air pocket will prolong the window of potential survival.BACKGROUNDSurvival from avalanche burial is dependent on time to extraction, breathing ability, air pocket oxygen content, and avoiding rebreathing of carbon dioxide (CO2). Mortality from asphyxia increases rapidly after burial. Rescue services often arrive too late. Our objective was to evaluate the physiological effects of providing personal air supply in a simulated avalanche scenario as a possible concept to delay asphyxia. We hypothesize that supplemental air toward victim's face into the air pocket will prolong the window of potential survival.A prospective randomized crossover experimental field study enrolled 20 healthy subjects in Hemsedal, Norway in March 2019. Subjects underwent in randomized order two sessions (receiving 2 litres per minute of air in front of mouth/nose into the air pocket or no air) in a simulated avalanche scenario with extensive monitoring serving as their own control.METHODSA prospective randomized crossover experimental field study enrolled 20 healthy subjects in Hemsedal, Norway in March 2019. Subjects underwent in randomized order two sessions (receiving 2 litres per minute of air in front of mouth/nose into the air pocket or no air) in a simulated avalanche scenario with extensive monitoring serving as their own control.A significant increase comparing Control vs Intervention were documented for minimum and maximum end-tidal CO2 (EtCO2), respiration rate, tidal volume, minute ventilation, heart rate, invasive arterial blood pressures, but lower peripheral and cerebral oximetry. Controls compared to Intervention group subjects had a lower study completion rate (26% vs 74%), and minutes in the air pocket before interruption (13.1 ± 8.1 vs 22.4 ± 5.6 vs), respectively.RESULTSA significant increase comparing Control vs Intervention were documented for minimum and maximum end-tidal CO2 (EtCO2), respiration rate, tidal volume, minute ventilation, heart rate, invasive arterial blood pressures, but lower peripheral and cerebral oximetry. Controls compared to Intervention group subjects had a lower study completion rate (26% vs 74%), and minutes in the air pocket before interruption (13.1 ± 8.1 vs 22.4 ± 5.6 vs), respectively.Participants subject to simulated avalanche burial can maintain physiologic parameters within normal levels for a significantly longer period if they receive supplemental air in front of their mouth/nose into the air pocket. This may extend the time for potential rescue and lead to increased survival.CONCLUSIONSParticipants subject to simulated avalanche burial can maintain physiologic parameters within normal levels for a significantly longer period if they receive supplemental air in front of their mouth/nose into the air pocket. This may extend the time for potential rescue and lead to increased survival. |
| Author | Østerås, Øyvind Brattebø, Guttorm Mydske, Sigurd Assmus, Jörg Skaalhegg, Tore Thomassen, Øyvind Wik, Lars Skaiaa, Sven Christjar Irusta, Unai Aramendi, Elisabete |
| Author_xml | – sequence: 1 givenname: Lars surname: Wik fullname: Wik, Lars email: lars.wik@medisin.uio.no organization: National Service of Competence for Prehospital Acute Medicine (NAKOS), Ullevål Hospital, Oslo, Norway – sequence: 2 givenname: Guttorm surname: Brattebø fullname: Brattebø, Guttorm organization: Department of Clinical Medicine, University of Bergen, Norway – sequence: 3 givenname: Øyvind surname: Østerås fullname: Østerås, Øyvind organization: Department of Anaesthesia and Intensive Care, Haukeland University Hospital, Bergen, Norway – sequence: 4 givenname: Jörg surname: Assmus fullname: Assmus, Jörg organization: Centre for Clinical Research, Haukeland University Hospital and University of Bergen, Bergen, Norway – sequence: 5 givenname: Unai surname: Irusta fullname: Irusta, Unai organization: University of the Basque Country, Faculty of Engineering, BioRes Group, Bilbao, Spain – sequence: 6 givenname: Elisabete surname: Aramendi fullname: Aramendi, Elisabete organization: University of the Basque Country, Faculty of Engineering, BioRes Group, Bilbao, Spain – sequence: 7 givenname: Sigurd surname: Mydske fullname: Mydske, Sigurd organization: Department of Medicine, Haukeland University Hospital, Bergen, Norway – sequence: 8 givenname: Tore surname: Skaalhegg fullname: Skaalhegg, Tore organization: Prehospital Clinic, Doctor Car, Oslo University Hospital HF, Ullevål Hospital, Oslo, Norway – sequence: 9 givenname: Sven Christjar surname: Skaiaa fullname: Skaiaa, Sven Christjar organization: Air Ambulance department, SARS, Oslo University Hospital HF, Ullevål Hospital, Oslo, Norway – sequence: 10 givenname: Øyvind surname: Thomassen fullname: Thomassen, Øyvind organization: Department of Clinical Medicine, University of Bergen, Norway |
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| Keywords | Air supply Air pocket Asphyxia Avalanche |
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| Title | Physiological effects of providing supplemental air for avalanche victims. A randomised trial |
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