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[Emergency airway management-- comparison of various strategies in an unsecured airway].
Wien Klin Wochenschr. 2001 Mar 15; 113(5-6):186-93.WK

Abstract

OBJECTIVES

Gastric inflation and regurgitation of stomach contents are major hazards of bag-valve-mask ventilation in an emergency. The purpose of our study was to determine lung ventilation and gastric inflation when using the bag-valve-face mask, laryngeal mask, and combitube with different sizes of self-inflating bags (max. volume: 700, 1100, 1500 ml).

METHODS

Twenty-six training emergency doctors without prior extensive training in emergency airway management volunteered for our study and ventilated a bench model simulating an unintubated respiratory arrest patient with bag-valve-face mask, laryngeal mask, and combitube using paediatric, medium size, and adult self-inflating bags. Lung and gastric tidal volume, as well as lung and gastric peak airway pressure were measured with respiratory monitors and a pneumotachometer.

RESULTS

When using either the combitube or the laryngeal mask, the paediatric vs. medium-size and adult self-inflating bag resulted in significantly (P < .001) lower mean +/- SEM lung tidal volumes (328 +/- 34 vs. 626 +/- 65 vs. 654 +/- 69 ml; and 368 +/- 30 vs. 532 +/- 48 vs. 692 +/- 67 ml, respectively). No gastric inflation occurred with the combitube, while gastric inflation was comparably low when using the laryngeal mask with either ventilation bag (3 +/- 2 vs. 7 +/- 4 vs. 6 +/- 3 ml; P = NS). The paediatric vs. medium-size and adult self-inflating bag in combination with the bag-valve-face mask resulted in comparable lung tidal volumes (250 +/- 23 vs. 313 +/- 24 vs. 282 +/- 38 ml; P = NS); but significantly (P < .01) lower gastric tidal volumes (147 +/- 23 vs. 206 +/- 24 vs. 267 +/- 23 ml).

CONCLUSIONS

Both the laryngeal mask and the combitube proved to be valid alternatives for the bag-valve-face mask in our experimental model. The medium size self-inflating bag seems to be adequate when using either the laryngeal mask or the combitube.

Authors+Show Affiliations

Dörges V
Klinik für Anaesthesiologie, Medizinische Universität Lübeck, Bundesrepublik Deutschland. v.doerges@t-online.de
Ocker H
No affiliation info available
Neubert E
No affiliation info available
Schumann T
No affiliation info available
Wenzel V
No affiliation info available

MeSH

AdultCardiopulmonary ResuscitationFemaleHumansLaryngeal MasksMaleRespiration, ArtificialTidal Volume

Pub Type(s)

Comparative Study
Evaluation Study
Journal Article

Language

ger

PubMed ID

11293948

Citation

Dörges, V, et al. "[Emergency Airway Management-- Comparison of Various Strategies in an Unsecured Airway]." Wiener Klinische Wochenschrift, vol. 113, no. 5-6, 2001, pp. 186-93.
Dörges V, Ocker H, Neubert E, et al. [Emergency airway management-- comparison of various strategies in an unsecured airway]. Wien Klin Wochenschr. 2001;113(5-6):186-93.
Dörges, V., Ocker, H., Neubert, E., Schumann, T., & Wenzel, V. (2001). [Emergency airway management-- comparison of various strategies in an unsecured airway]. Wiener Klinische Wochenschrift, 113(5-6), 186-93.
Dörges V, et al. [Emergency Airway Management-- Comparison of Various Strategies in an Unsecured Airway]. Wien Klin Wochenschr. 2001 Mar 15;113(5-6):186-93. PubMed PMID: 11293948.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Emergency airway management-- comparison of various strategies in an unsecured airway]. AU - Dörges,V, AU - Ocker,H, AU - Neubert,E, AU - Schumann,T, AU - Wenzel,V, PY - 2001/4/11/pubmed PY - 2001/5/18/medline PY - 2001/4/11/entrez SP - 186 EP - 93 JF - Wiener klinische Wochenschrift JO - Wien Klin Wochenschr VL - 113 IS - 5-6 N2 - OBJECTIVES: Gastric inflation and regurgitation of stomach contents are major hazards of bag-valve-mask ventilation in an emergency. The purpose of our study was to determine lung ventilation and gastric inflation when using the bag-valve-face mask, laryngeal mask, and combitube with different sizes of self-inflating bags (max. volume: 700, 1100, 1500 ml). METHODS: Twenty-six training emergency doctors without prior extensive training in emergency airway management volunteered for our study and ventilated a bench model simulating an unintubated respiratory arrest patient with bag-valve-face mask, laryngeal mask, and combitube using paediatric, medium size, and adult self-inflating bags. Lung and gastric tidal volume, as well as lung and gastric peak airway pressure were measured with respiratory monitors and a pneumotachometer. RESULTS: When using either the combitube or the laryngeal mask, the paediatric vs. medium-size and adult self-inflating bag resulted in significantly (P < .001) lower mean +/- SEM lung tidal volumes (328 +/- 34 vs. 626 +/- 65 vs. 654 +/- 69 ml; and 368 +/- 30 vs. 532 +/- 48 vs. 692 +/- 67 ml, respectively). No gastric inflation occurred with the combitube, while gastric inflation was comparably low when using the laryngeal mask with either ventilation bag (3 +/- 2 vs. 7 +/- 4 vs. 6 +/- 3 ml; P = NS). The paediatric vs. medium-size and adult self-inflating bag in combination with the bag-valve-face mask resulted in comparable lung tidal volumes (250 +/- 23 vs. 313 +/- 24 vs. 282 +/- 38 ml; P = NS); but significantly (P < .01) lower gastric tidal volumes (147 +/- 23 vs. 206 +/- 24 vs. 267 +/- 23 ml). CONCLUSIONS: Both the laryngeal mask and the combitube proved to be valid alternatives for the bag-valve-face mask in our experimental model. The medium size self-inflating bag seems to be adequate when using either the laryngeal mask or the combitube. SN - 0043-5325 UR - https://www.unboundmedicine.com/medline/citation/11293948/[Emergency_airway_management___comparison_of_various_strategies_in_an_unsecured_airway]_ DB - PRIME DP - Unbound Medicine ER -