Mechanics of Breathing in Relation to Manual Methods of Artificial Respiration

Abstract

Instantaneous air-flow rates and pulmonary ventilation volumes were measured in 8 apneic living patients during manual artificial respiration by 3 methods, the Holger Nielsen, the hip-lift, back pressure, and the Schafer prone pressure. Most of the patients were apneic and comatose because of intra-cerebral hemorrhage. In 2 patients static pressure-volume relationships of the chest were measured before and after death. Pulmonary ventilation with the forced expiration method (Schafer) was not adequate. Excellent ventilation was obtained with the 2 other methods which had an active inspiratory phase as well as an active expiratory phase. The active inspiratory phase resulted from elevation of the hips or lifting the upper arms, with the patient in a prone position. Air-flow recording was considered valuable in determining the optimum timing of the manual sequences. The ante- and post-mortem pressure-volume diagrams of the lungs and thorax indicated that no change in distensibility or elasticity occurred at the time of death. Clinical summaries are included.