A human immunodeficiency virus-resistant airway for cardiopulmonary resuscitation.

Due to fear of transmitted disease, mouth-to-mouth cardiopulmonary resuscitation (CPR) is now rare, even though early CPR is associated with a fivefold to 30-fold increase in survival. The authors have devised a one-piece silicone mask (Kiss of Life KOL], Brunswick Biomedical Technologies, Inc, Warehom, MA) with a one-way valve and circular recess to form a no-contact lip seal, enabling mouth-to-mouth CPR to be given. The ventilatory volume during mannequin CPR using the KOL mask was 0.75 +/- 0.235 L. This volume was significantly (P less than .05) greater than that generated by alternate widely used airways (range, 0.195 +/- 0.147 to 0.617 +/- 0.208 L). To assess mask performance in vivo, the authors measured exhaled volumes in 10 apneic anesthetized patients under three conditions: with the KOL mask, a standard anesthetic mask and bag, and an anesthetic mask with an endotracheal tube. The results were: anesthetic mask and tube, 1.5 L (range, 1.2 to 1.7 L); KOL mask, 1.1 L (range, 1.0 to 1.3 L); anesthetic mask alone, 0.7 L (range, 0.5 to 0.8 L). To test permeability, we exposed two KOL masks to a high titer of human immunodeficiency virus (HIV)-1 soup (10(6) culture infection doses/mL) for 10 and eight masks for 60 minutes, respectively, and cultured swabs of the interior of the valve for 1 month. There was no growth in any culture. These data suggest that the KOL mask has excellent ventilating characteristics, is practical (pocket-portable, disposable), experimentally impermeable to HIV-1, and inexpensive.(ABSTRACT TRUNCATED AT 250 WORDS)