The effect of a manometer on the mean airway pressure during hand ventilation, an in vitro study

Karsdon, Jeffrey; Stijnen, T.; Berger, Howard

doi:10.1007/bf00441562

Cited by 9 publications

(5 citation statements)

References 16 publications

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“…Our results demonstrated flow‐inflating resuscitators using manometry were superior to self‐inflating resuscitators without a manometer in achieving targeted ventilator parameters. These results are in keeping with previous studies demonstrating manual resuscitator use with manometry reduces variation in delivered tidal volumes and peak ventilation pressures . The initial decision to exclude a pressure manometer within the self‐inflating resuscitator arm was based on its absence in common practice.…”

Section: Introductionsupporting

confidence: 85%

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Artificial ventilation during transport: A randomized crossover study of manual resuscitators with comparison to mechanical ventilators in a simulation model

Lucy

Gamble

Peeling

et al. 2018

Pediatric Anesthesia

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This study demonstrates that a majority of breaths delivered by manual resuscitation device fall outside of target range regardless of provider experience or device type. The mechanical ventilator (Hamilton-T1) outperforms the other positive-pressure ventilation methods with respect to delivery of important ventilation parameters. In contrast, 100% of breaths delivered by the LTV 1200 were deemed unacceptable.

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Section: Introductionsupporting

confidence: 85%

“…These results are in keeping with previous studies demonstrating manual resuscitator use with manometry reduces variation in delivered tidal volumes and peak ventilation pressures. 10,11 The initial decision to exclude a pressure manometer within the self-inflating resuscitator arm was based on its absence in common practice.…”

Section: Introductionmentioning

confidence: 99%

Artificial ventilation during transport: A randomized crossover study of manual resuscitators with comparison to mechanical ventilators in a simulation model

Lucy

Gamble

Peeling

et al. 2018

Pediatric Anesthesia

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show abstract

“…A potential criticism of our study is that a pressure manometer was only used with the FIR, which could bias our results. Certainly, the use of a pressure manometer in conjunction with hand ventilation has been shown to limit excessive peak inspiratory pressure generation and increase the consistency of tidal volumes in simulation models . FIR, by convention, typically use pressure manometers as a mechanism of safety to avoid accidental barotrauma and volutrauma and to measure PEEP.…”

Section: Discussionmentioning

confidence: 99%

Positive‐pressure ventilation during transport: a randomized crossover study of self‐inflating and flow‐inflating resuscitators in a simulation model

Lucy

Gamble

Daku

et al. 2014

Pediatric Anesthesia

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“…15 What has been shown to enhance ventilation performance with the anaesthesia bag is the attachment of a manometer, allowing more controlled ventilation in terms of peak pressures generated and overall mean airway pressure and thus oxygenation. 16 17 Zmora and Merritt 16 examined manual ventilation of a mannequin by paediatric staff both with and without a manometer. Target inspiratory pressures were achieved by 72% using a manometer in contrast with 18% without.…”

Section: Discussionmentioning

confidence: 99%

Comparison of three manual ventilation devices using an intubated mannequin

Hussey

2004

Archives of Disease in Childhood - Fetal and Neonatal Edition

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Objective: To compare three devices for manual neonatal ventilation. Design: Participants performed a two minute period of ventilation using a self inflating device, an anaesthesia bag with attached manometer, and a Neopuff device. An intubated neonatal mannequin, approximating a 1 kg infant with functional lungs, was used for the study. Target ventilation variables included a rate of 40 breaths per minute, peak inspiratory pressure (PIP) of 20 cm H 2 O, and positive end expiratory pressure (PEEP) of 4 cm H 2 O. The circuit was attached to a laptop computer for data recording. Results: Thirty five participants were enrolled, including consultant neonatologists, paediatricians, and anaesthetists, paediatric and anaesthetic registrars, and neonatal nurses. The maximum PIP recorded using the self inflating bag, anaesthetic bag, and Neopuff device were 75.9, 35.5, and 22.4 cm H 2 O respectively. There were significant differences between the devices for mean PIP (30.7,18.1, and 20.1 cm H 2 O), mean PEEP (0.2, 2.8, and 4.4 cm H 2 O), mean airway pressure (7.6, 8.5, and 10.9 cm H 2 O), % total breaths ( 21 cm H 2 O PIP (39%, 92%, and 98%), and % total breaths > 30 cm H 2 O PIP (45%, 0, and 0). There was no difference between doctors and allied health professionals for the variables examined. Conclusion: The anaesthetic bag with manometer and Neopuff device both facilitate accurate and reproducible manual ventilation. Self inflating devices without modifications are not as consistent by comparison and should incorporate a manometer and a PEEP device, particularly when used for resuscitation of very low birthweight infants.T he reported need for positive pressure ventilation in newborn infants has varied from about 2% in the 1970s to 1% in the early 1990s.1-3 Infants receiving ventilatory support often require brief periods of manual ventilation for reasons including acute deterioration, equipment failure, patient transfer, and clinical assessment. 4 Loss of face mask seal and loss of pressure in the ventilation bag can lead to inadequate resuscitation.5 Although ventilation is essential for resuscitation, excessive inspiratory pressures can lead to volutrauma, particularly in very low birthweight infants. [6][7][8] Inadequate positive end expiratory pressure (PEEP) and the resultant inadequate end expiratory lung volume augments lung injury by allowing repetitive expansion and collapse of the terminal airways and alveolar units (atelectrauma). 9There are several methods of providing manual ventilation. Self inflating devices are operated by squeezing and releasing a semirigid silicone bag to deliver each breath to the patient. They are portable and easy to use. They usually include a pressure limiting safety valve and can deliver room air without an independent gas flow. Flow dependent anaesthesia bags are squeezed to deliver each breath, and pressure release valves can be attached to limit peak pressures. Their accurate use requires training and skill but they can facilitate both prolonged inspirations and PEEP. The N...

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The effect of a manometer on the mean airway pressure during hand ventilation, an in vitro study

Cited by 9 publications

References 16 publications

Artificial ventilation during transport: A randomized crossover study of manual resuscitators with comparison to mechanical ventilators in a simulation model

Artificial ventilation during transport: A randomized crossover study of manual resuscitators with comparison to mechanical ventilators in a simulation model

Positive‐pressure ventilation during transport: a randomized crossover study of self‐inflating and flow‐inflating resuscitators in a simulation model

Comparison of three manual ventilation devices using an intubated mannequin

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