To intubate or not: ventilation is the question. A manikin-based observational study
| Autor: | Lionel Pazart, Abdo Khoury, Gilles Capellier, F. S. Sall, Aurore Pugin, Alban De Luca |
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| Rok vydání: | 2018 |
| Předmět: |
Non-Invasive Ventilation
Pulmonary and Respiratory Medicine business.industry medicine.medical_treatment Respiratory arrest equipment evaluations 030208 emergency & critical care medicine Endotracheal intubation 030204 cardiovascular system & hematology law.invention 03 medical and health sciences 0302 clinical medicine law Anesthesia Hyperventilation Ventilation (architecture) medicine Observational study In patient Cardiopulmonary resuscitation Lung simulator medicine.symptom business |
| Zdroj: | BMJ Open Respiratory Research |
| ISSN: | 2052-4439 |
| Popis: | IntroductionThere is a continuous debate concerning the superiority of endotracheal intubation on bag-valve-mask (BVM) ventilation in patients with cardiac arrest. In this manikin-based observational study, we evaluate and compare the performance of manual ventilation through a facemask (BVM) and an endotracheal tube (ETT).MethodsOne hundred and forty healthcare providers were instructed to manually ventilate a manikin as they would do for a 75 kg adult patient in respiratory arrest. Each one was ventilating both through a facemask and an ETT for a 5 min period in a random order. Ventilatory parameters were measured by the ASL 5000 lung simulator and ventilation performance was analysed using a sliding window method published in a previous study to assess accurately ventilation efficiency.ResultsThe mean ventilation rate was high whatever the technique used (24 bpm). A weak relationship between manual ventilation performance and the type of interface used was observed (p=0.0484). The overall rate of adequate ventilation was low even if we noticed a slight improvement when ventilating through an ETT (13.21% vs 7.5% of adequate ventilation). However, the rate of hyperventilation did not differ between mask and tube (79% vs 77%). A significant relationship is observed between professional category, the size of the hand squeezing the bag and manual ventilation performance (pConclusionWhatever the interface used, healthcare professionals are still struggling to perform manual ventilation efficiently according to international guidelines. Ventilation with an ETT does not prove to be significantly more efficient than with a facemask. It would be therefore important to recentre the debate on controlling ventilatory parameters with current devices. Focusing on training may maximise manual ventilation efficiency and minimise the loss of time during cardiopulmonary resuscitation. |
| Databáze: | OpenAIRE |
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