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  • Title: The mouth-to-bag resuscitator during standard anaesthesia induction in apnoeic patients.
    Author: Herff H, Paal P, Mitterlechner T, von Goedecke A, Stadlbauer KH, Voelckel WG, Zecha-Stallinger A, Wenzel V.
    Journal: Resuscitation; 2009 Oct; 80(10):1142-6. PubMed ID: 19674827.
    Abstract:
    AIM: Ventilation of a non-intubated emergency patient by inexperienced rescuers with a standard bag-valve device may result in high inspiratory flow rates and subsequently high airway pressures with stomach inflation. Therefore, a self-inflating bag has been developed that requires lay rescuers to blow up a single-use balloon inside an adult bag-valve device, which, in turn, displaces air within the bag towards the patient. This concept has been compared to standard adult bag-valve devices earlier in bench models but not in patients. METHODS: An anaesthetist who was blinded to all monitor tracings ventilated the lungs of 40 apnoeic patients during routine anaesthesia induction either with a standard bag-valve device or with the mouth-to-bag resuscitator in a random order. Study endpoints were peak inspiratory flow rates, peak airway pressure, tidal volumes and inspiratory time. RESULTS: Peak inspiratory flow was 40+/-10lmin(-1) for the standard bag-valve device versus 33+/-13lmin(-1) for the mouth-to-bag resuscitator (P<0.0001); peak airway pressure was 17+/-5cmH(2)O versus 14+/-5cmH(2)O (P<0.0001); inspiratory tidal volume was 477+/-133ml versus 644+/-248ml (P<0.001) and inspiratory time was 1.1+/-0.3s versus 1.9+/-0.6s (P<0.0001). CONCLUSION: Employing the mouth-to-bag resuscitator during simulated ventilation of a non-intubated patient in respiratory arrest significantly decreased peak inspiratory flow and peak airway pressure and increased inspiratory tidal volume and inspiratory times compared to a standard bag-valve device.
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