Document Detail

Effects of face mask ventilation in apneic patients with a resuscitation ventilator in comparison with a bag-valve-mask.
MedLine Citation:
PMID:  16434338     Owner:  NLM     Status:  MEDLINE    
Bag-valve-mask ventilation in an unprotected airway is often applied with a high flow rate or a short inflation time and, therefore, a high peak airway pressure, which may increase the risk of stomach inflation and subsequent pulmonary aspiration. Strategies to provide more patient safety may be a reduction in inspiratory flow and, therefore, peak airway pressure. The purpose of this study was to evaluate the effects of bag-valve-mask ventilation vs. a resuscitation ventilator on tidal volume, peak airway pressure, and peak inspiratory flow rate in apneic patients. In a crossover design, 40 adults were ventilated during induction of anesthesia with either a bag-valve-mask device with room air, or an oxygen-powered, flow-limited resuscitation ventilator. The study endpoints of expired tidal volume, minute volume, respiratory rate, peak airway pressure, delta airway pressure, peak inspiratory flow rate and inspiratory time fraction were measured using a pulmonary monitor. When compared with the resuscitation ventilator, the bag-valve-mask resulted in significantly higher (mean+/-SD) peak airway pressure (15.3+/-3 vs. 14.1+/-3 cm H2O, respectively; p=0.001) and delta airway pressure (14+/-3 vs. 12+/-3 cm H2O, respectively; p<0.001), but significantly lower oxygen saturation (95+/-3 vs. 98+/-1%, respectively; p<0.001). No patient in either group had clinically detectable stomach inflation. We conclude that the resuscitation ventilator is at least as effective as traditional bag-valve-mask or face mask resuscitation in this population of very controlled elective surgery patients.
Achim von Goedecke; Volker Wenzel; Christoph Hörmann; Wolfgang G Voelckel; Horst G Wagner-Berger; Angelika Zecha-Stallinger; Thomas J Luger; Christian Keller
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Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The Journal of emergency medicine     Volume:  30     ISSN:  0736-4679     ISO Abbreviation:  J Emerg Med     Publication Date:  2006 Jan 
Date Detail:
Created Date:  2006-01-25     Completed Date:  2006-08-10     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8412174     Medline TA:  J Emerg Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  63-7     Citation Subset:  IM    
Department of Anesthesiology and Critical Care Medicine, Medical University of Innsbruck, Innsbruck, Austria.
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MeSH Terms
Apnea / therapy*
Cross-Over Studies
Laryngeal Masks*
Prospective Studies
Pulmonary Ventilation*
Respiratory Mechanics
Resuscitation / instrumentation*
Treatment Outcome
Ventilators, Mechanical*
Comment In:
J Emerg Med. 2006 Jan;30(1):97-8   [PMID:  16434346 ]

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