JOURNAL HOME CME HOME THIS MONTH PAST ISSUES ETOC COLLECTIONS
AUTHORS REVIEWERS EDITORIAL BOARD FEEDBACK RSS HELP
A&A International Anesthesia Research Society
QUICK SEARCH:   [advanced]


     

This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a colleague
Right arrow Similar articles in this journal
Right arrow Similar articles in ISI Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Citing Articles
Right arrow Citing Articles via ISI Web of Science (1)
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by von Goedecke, A.
Right arrow Articles by Wenzel, V.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by von Goedecke, A.
Right arrow Articles by Wenzel, V.
Related Collections
Right arrow Resuscitation
Right arrow Critical Care
Right arrow Airway

Anesth Analg 2004;99:1516-1520
© 2004 International Anesthesia Research Society
doi: 10.1213/01.ANE.0000133581.31782.EC

CRITICAL CARE AND TRAUMA

Developing a Strategy to Improve Ventilation in an Unprotected Airway with a Modified Mouth-to-Bag Resuscitator in Apneic Patients

Achim von Goedecke, MD, Christian Keller, MD, Horst G. Wagner-Berger, MD, Wolfgang G. Voelckel, MD, Christoph Hörmann, MD, Angelika Zecha-Stallinger, MD, and Volker Wenzel, MD

Department of Anesthesiology and Critical Care Medicine, Medical University, Innsbruck, Austria

Address correspondence and reprint requests to Dr. Achim von Goedecke, Department of Anesthesiology and Critical Care Medicine, Medical University of Innsbruck, Anichstrasse 35, 6020 Innsbruck, Austria. Address e-mail to achim.von-goedecke{at}uibk.ac.at

The strategies to ensure safety during ventilation of an unprotected airway are limiting airway pressure and/or inspiratory flow. In this prospective, randomized study we assessed the effect of face mask ventilation with small tidal volumes in the modified mouth-to-bag resuscitator (maximal volume, 500 mL) versus a pediatric self-inflatable bag versus automatic pressure-controlled ventilation in 40 adult apneic patients during induction of anesthesia. The mouth-to-bag resuscitator requires the rescuer to blow up a balloon inside the self-inflating bag that subsequently displaces air which then flows into the patient’s airway. Respiratory variables were measured with a pulmonary monitor (CP-100). Mouth-to-bag resuscitator and pressure-controlled ventilation resulted in significantly lower (mean ± SD) peak airway pressure (8 ± 2 and 8 ± 1 cm H2O), peak inspiratory flow rate (0.7 ± 0.1 and 0.7 ± 0.1 L/s), and larger inspiratory time fraction (33% ± 5% and 47% ± 2%) in comparison to pediatric self-inflating bag ventilation (12 ± 3 cm H2O; 1 ± 0.2 L/s; 27% ± 4%; all P < 0.001). The tidal volumes were similar between groups. No stomach inflation occurred in either group. We conclude that using a modified mouth-to-bag resuscitator or automatic pressure-controlled ventilation with similar small tidal volumes during face mask ventilation resulted in an approximately 25% reduction in peak airway pressure when compared with a standard pediatric self-inflating bag.

IMPLICATIONS: Using a modified mouth-to-bag resuscitator or automatic pressure-controlled ventilation during ventilation of an unprotected airway resulted in an approximately 25% reduction in peak flow rate and peak airway pressure when compared with a pediatric self-inflating bag.






Lippincott, Williams & Wilkins Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999 HighWire Press
Copyright © 2004 by the International Anesthesia Research Society.