Basic life support trained nurses ventilate more efficiently with laryngeal mask supreme than with facemask or laryngeal tube suction-disposable--a prospective, randomized clinical trial
Autor: | Karla Balkenhol, Elisabeth Gruber, Hermann Brugger, Peter Paal, Giacomo Strapazzon, Markus Falk, Emily Procter, Rosmarie Oberhammer |
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Rok vydání: | 2013 |
Předmět: |
Suction (medicine)
Laryngeal tube Adult Male medicine.medical_treatment Emergency Nursing Suction Laryngeal Masks law.invention law Tidal Volume Medicine Humans Prospective Studies Elective surgery Disposable Equipment Aged business.industry Basic life support Middle Aged Respiration Artificial Advanced life support Life Support Care Anesthesia Ventilation (architecture) Emergency Medicine Airway management Female Curriculum Cardiology and Cardiovascular Medicine business Airway |
Zdroj: | Resuscitation. 85(4) |
ISSN: | 1873-1570 |
Popis: | In some emergency situations resuscitation and ventilation may have to be performed by basic life support trained personnel, especially in rural areas where arrival of advanced life support teams can be delayed. The use of advanced airway devices such as endotracheal intubation has been deemphasized for basically-trained personnel, but it is unclear whether supraglottic airway devices are advisable over traditional mask-ventilation.In this prospective, randomized clinical single-centre trial we compared airway management and ventilation performed by nurses using facemask, laryngeal mask Supreme (LMA-S) and laryngeal tube suction-disposable (LTS-D). Basic life support trained nurses (n=20) received one-hour practical training with each device. ASA 1-2 patients scheduled for elective surgery were included (n=150). After induction of anaesthesia and neuromuscular block nurses had two 90-second attempts to manage the airway and ventilate the patient with volume-controlled ventilation.Ventilation failed in 34% of patients with facemask, 2% with LMA-S and 22% with LTS-D (P0.001). In patients who could be ventilated successfully mean tidal volume was 240±210 ml with facemask, 470±120 ml with LMA-S and 470±140 ml with LTS-D (P0.001). Leak pressure was lower with LMA-S (23.3±10.8 cm H2O, 95% CI 20.2-26.4) than with LTS-D (28.9±13.9 cm·H2O, 95% CI 24.4-33.4; P=0.047).After one hour of introductory training, nurses were able to use LMA-S more effectively than facemask and LTS-D. High ventilation failure rates with facemask and LTS-D may indicate that additional training is required to perform airway management adequately with these devices. High-level trials are needed to confirm these results in cardiac arrest patients. |
Databáze: | OpenAIRE |
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