Tags

Type your tag names separated by a space and hit enter

Ventilation strategies in the obstructed airway in a bench model simulating a nonintubated respiratory arrest patient.
Anesth Analg. 2009 May; 108(5):1585-8.A&A

Abstract

BACKGROUND

The Smart Bag MO(R) is an adult flow-limited bag-valve device designed to reduce the risk of stomach inflation in an unprotected airway. Its properties in severe airway obstruction are as yet unknown.

METHODS

In a bench model, we evaluated respiratory mechanics and delivered tidal volumes although ventilating at airway resistances of 4, 10, and 20 cm H(2)O . L(-1) . s(-1) once with a flow-limited bag-valve device and once with a standard bag-valve device to simulate a respiratory arrest patient with an unprotected airway.

RESULTS

Inspiratory times were always longer with the flow-limited bag-valve device than with the standard bag-valve device. Lung tidal volume in the simulated unobstructed airway was 750 +/- 70 mL using the flow-limited bag-valve device versus 780 +/- 30 mL using the standard bag-valve device (n.s.); in the simulated medium obstructed airway it was 800 +/- 70 versus 850 +/- 20 mL (n.s.), and in the simulated severely obstructed airway it was 210 +/- 20 versus 170 +/- 10 mL (P < 0.01). Peak airway pressure in the simulated unobstructed airway was 15 +/- 2 cm H(2)O using the flow-limited bag-valve device versus 22 +/- 4 cm H(2)O using the standard bag-valve device (P < 0.01); in the simulated medium obstructed airway it was 22 +/- 1 versus 39 +/- 7 cm H(2)O (P < 0.01), and in the simulated severely obstructed airway it was 26 +/- 1 versus 61 +/- 3 cm H(2)O (P < 0.01). Stomach inflation in the simulated unobstructed airway was 0 mL/min using both bag-valve devices; in the simulated medium obstructed airway it was 0 mL/min for the flow-limited bag-valve device versus 200 +/- 20 mL/min for the standard bag-valve device (P < 0.01), and in the simulated severely obstructed airway it was 0 versus 1240 +/- 50 mL/min (P < 0.01).

CONCLUSION

In a simulated severely obstructed unprotected airway, the use of a flow-limited bag-valve device resulted in longer inspiratory times, higher tidal volumes, lower inspiratory pressures, and no stomach inflation compared with a standard bag-valve device.

Links

Publisher Full Text (DOI)

Authors+Show Affiliations

Herff H
Department of Anesthesiology and Critical Care Medicine, Innsbruck Medical University, Innsbruck, Austria. holger.herff@i-med.ac.a
Paal P
No affiliation info available
von Goedecke A
No affiliation info available
Mitterlechner T
No affiliation info available
Schmittinger CA
No affiliation info available
Wenzel V
No affiliation info available

MeSH

AdultAirway ObstructionEquipment DesignHumansInhalationInsufflationModels, AnatomicPressureRespiration, ArtificialRespiratory InsufficiencyRespiratory MechanicsSeverity of Illness IndexStomach DiseasesTidal VolumeTreatment Outcome

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

19372339

Citation

Herff, Holger, et al. "Ventilation Strategies in the Obstructed Airway in a Bench Model Simulating a Nonintubated Respiratory Arrest Patient." Anesthesia and Analgesia, vol. 108, no. 5, 2009, pp. 1585-8.
Herff H, Paal P, von Goedecke A, et al. Ventilation strategies in the obstructed airway in a bench model simulating a nonintubated respiratory arrest patient. Anesth Analg. 2009;108(5):1585-8.
Herff, H., Paal, P., von Goedecke, A., Mitterlechner, T., Schmittinger, C. A., & Wenzel, V. (2009). Ventilation strategies in the obstructed airway in a bench model simulating a nonintubated respiratory arrest patient. Anesthesia and Analgesia, 108(5), 1585-8. https://doi.org/10.1213/ane.0b013e31819f32a6
Herff H, et al. Ventilation Strategies in the Obstructed Airway in a Bench Model Simulating a Nonintubated Respiratory Arrest Patient. Anesth Analg. 2009;108(5):1585-8. PubMed PMID: 19372339.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Ventilation strategies in the obstructed airway in a bench model simulating a nonintubated respiratory arrest patient. AU - Herff,Holger, AU - Paal,Peter, AU - von Goedecke,Achim, AU - Mitterlechner,Thomas, AU - Schmittinger,Christian A, AU - Wenzel,Volker, PY - 2009/4/18/entrez PY - 2009/4/18/pubmed PY - 2009/5/1/medline SP - 1585 EP - 8 JF - Anesthesia and analgesia JO - Anesth Analg VL - 108 IS - 5 N2 - BACKGROUND: The Smart Bag MO(R) is an adult flow-limited bag-valve device designed to reduce the risk of stomach inflation in an unprotected airway. Its properties in severe airway obstruction are as yet unknown. METHODS: In a bench model, we evaluated respiratory mechanics and delivered tidal volumes although ventilating at airway resistances of 4, 10, and 20 cm H(2)O . L(-1) . s(-1) once with a flow-limited bag-valve device and once with a standard bag-valve device to simulate a respiratory arrest patient with an unprotected airway. RESULTS: Inspiratory times were always longer with the flow-limited bag-valve device than with the standard bag-valve device. Lung tidal volume in the simulated unobstructed airway was 750 +/- 70 mL using the flow-limited bag-valve device versus 780 +/- 30 mL using the standard bag-valve device (n.s.); in the simulated medium obstructed airway it was 800 +/- 70 versus 850 +/- 20 mL (n.s.), and in the simulated severely obstructed airway it was 210 +/- 20 versus 170 +/- 10 mL (P < 0.01). Peak airway pressure in the simulated unobstructed airway was 15 +/- 2 cm H(2)O using the flow-limited bag-valve device versus 22 +/- 4 cm H(2)O using the standard bag-valve device (P < 0.01); in the simulated medium obstructed airway it was 22 +/- 1 versus 39 +/- 7 cm H(2)O (P < 0.01), and in the simulated severely obstructed airway it was 26 +/- 1 versus 61 +/- 3 cm H(2)O (P < 0.01). Stomach inflation in the simulated unobstructed airway was 0 mL/min using both bag-valve devices; in the simulated medium obstructed airway it was 0 mL/min for the flow-limited bag-valve device versus 200 +/- 20 mL/min for the standard bag-valve device (P < 0.01), and in the simulated severely obstructed airway it was 0 versus 1240 +/- 50 mL/min (P < 0.01). CONCLUSION: In a simulated severely obstructed unprotected airway, the use of a flow-limited bag-valve device resulted in longer inspiratory times, higher tidal volumes, lower inspiratory pressures, and no stomach inflation compared with a standard bag-valve device. SN - 1526-7598 UR - https://www.unboundmedicine.com/medline/citation/19372339/Ventilation_strategies_in_the_obstructed_airway_in_a_bench_model_simulating_a_nonintubated_respiratory_arrest_patient_ DB - PRIME DP - Unbound Medicine ER -