Stomach Distension During CPR: Causes and Corrective Actions

Gastric inflation during rescue breaths is a common, problematic complication. Causes:

1. Inadequate Chest Compressions: Insufficient depth/rate fails to create forward flow; air enters stomach instead.
2. Excessive Ventilation Volume/Pressure: Over-inflation forces air past the esophageal sphincter.
3. Poor Airway Position: Head not tilted/chin lifted → airway not fully open.
4. Anatomical Factors: Hiatal hernia, high diaphragm, obesity increase risk.

Consequences

• Reduced lung ventilation (diaphragm splinted)
• Regurgitation/aspiration risk
• Decreased venous return (intrathoracic pressure)

Prevention & Correction

• High-quality compressions: 2–2.4 inches, 100–120/min, full recoil.
• Rescue breaths: 1 second, visible chest rise only (≈500–600 mL).
• Proper head-tilt/chin-lift or jaw thrust.
• Use bag-valve-mask with O₂ if available.
• If distension occurs: pause ventilations briefly, apply cricoid pressure (if trained), consider supraglottic airway.

Gastric inflation reduces CPR effectiveness; technique discipline is key.