Abstract
Gastric inflation is a significant issue when ventilation is performed in cases of
unprotected airway. The objective of this study was to compare the amounts of gastric
insufflation and tidal volumes produced by a hose-extended bag-valve-mask (BVM) device
supplemented by an interposed reservoir bag with a similar BVM without the reservoir
in a simulated human model. Fourteen academic dental staff members performed 10 ventilations
on a manikin using the reservoir-supplemented device in comparison to the control
BVM in a randomized order. Lung compliance was adjusted to 45 (high) and 4.5 mL/mbar
(low), and the lower esophageal sphincter pressure (LOSP) simulator to a pressure
of 15 and 3 mbar, respectively, in different settings. Lower tidal volumes were observed
with the new device than with the control BVM at high compliance with LOSP of 15 mbar
(median 506 vs. 787 mL, respectively; p = 0.0002) and LOSP of 3 mbar (median 544 vs. 794 mL, respectively; p = 0.0006), as well as during ventilation at low lung compliance and LOSP of 3mbar
(median 131 vs. 163 mL, respectively; p = 0.0342). No differences were detected at low lung compliance and LOSP of 15 mbar
(median 175 vs. 194 mL; p = 0.3804). Gastric inflation almost exclusively occurred in case of low lung compliance,
being markedly lower with the new device than with the control device at 15 mbar LOSP
(300 vs. 2225 mL, respectively; p = 0.0006), and at 3 mbar LOSP (1138 vs. 3050 mL, respectively; p = 0.0001). Application of the hose-extended bag-valve-mask device supplemented with
a reservoir bag reduces tidal volumes. Marked reduction of gastric inflation by use
of this device becomes effective under conditions with low lung compliance.
Keywords
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Article info
Publication history
Published online: May 20, 2008
Accepted:
November 2,
2007
Received in revised form:
April 29,
2007
Received:
February 2,
2007
Identification
Copyright
© 2010 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
