| Autor: |
Kalev Freeman, Zachary D. Miller, Robert Ramsey Herrington, Nathan T. Dreyfus, Philip Buttaravoli, Adam Burgess, Joshua P. Nickerson, Nirav Daphtary, Jason H. T. Bates |
| Jazyk: |
angličtina |
| Rok vydání: |
2021 |
| Předmět: |
|
| Zdroj: |
Journal of the American College of Emergency Physicians Open, Vol 2, Iss 2, Pp n/a-n/a (2021) |
| Druh dokumentu: |
article |
| ISSN: |
2688-1152 |
| DOI: |
10.1002/emp2.12440 |
| Popis: |
Abstract Objective No oropharyngeal devices exist for use in conscious and semiconscious trauma patients during emergency evacuation, transport, or resuscitation. We aimed to test the hypotheses that the ManMaxAirway (MMA) is better tolerated than the standard Guedel‐style device in awake volunteers and that it produces a jaw thrust and improves air flow. Methods This was a randomized cross‐over study of healthy volunteers with either the MMA or standard device. The primary outcome of tolerability was defined as maintaining the device in place for 60 seconds. Secondary outcomes included respiratory system function and jaw thrust. Resistance to airflow through the device lumen was measured in situ and when placed in subjects in the pulmonary laboratory alone. Jaw thrust was quantified as displacement between the mandibular condyle and condylar fossa apex relative to baseline visualized with magnetic resonance imaging (MRI). Results We enrolled 19 subjects. Of these, a convenience sample of 5 individuals was selected for MRI; the remaining individuals (n = 14) were randomized for the cross‐over study. All 14 subjects were able to maintain the MMA for 60 seconds compared with 2/14 (14%) with the standard device (odds ratio, 145; 95% confidence interval, 6.3‐3314). Subjects reported that the experimental device was more comfortable and its placement did not trigger the gag reflex. Airway resistance produced by the MMA in an oscillatory flow model was nearly an order of magnitude lower than that of the standard device (experimental vs standard, 8 Hz—0.092 vs 0.786 cmH20·s/L; 15 Hz—0.193 vs 1.321 cmH20·s/L). Rapid induction of the gag reflex precluded further measurements with the standard device. Forced oscillation pulmonary testing in conscious volunteers with and without the MMA demonstrated that the device decreased respiratory system resistance to airflow and reduced respiratory elastance (31% ± 8% and 44% ± 13.4%, respectively; P |
| Databáze: |
Directory of Open Access Journals |
| Externí odkaz: |
|
Plný text