Barnes Thomas A, Catino Melissa E, Burns Erin C, Chan Wing Kei, Ghazarian Garo, Henneberg Werner R, Ruel Kendra E, Stanley Scott A
Department of Cardiopulmonary and Exercise Sciences, Bouve College of Health Sciences, Northeastern University, Boston, Massachusetts 02115-5000, USA.
Respir Care. 2005 Nov;50(11):1445-50.
Positive-pressure ventilation of patients with unprotected airways during cardiopulmonary resuscitation can cause gastric dilation.
Determine if there is a significant difference in volume delivered to lungs and stomach while using an adult 1,000-mL disposable bag-valve-mask (BVM) device and the oxygen-powered, flow-limited Oxylator EMX resuscitator.
We used a bench model to simulate a patient with an unprotected airway, consisting of an intubation manikin, lung analog, and simulated lower esophageal sphincter set at an opening pressure of 20 cm H2O. The BVM and the Oxylator were used to provide mask ventilation at a verbally prompted rate of 12 breaths/min.
The volumes delivered with the BVM and the Oxylator to the lungs and stomach were not significantly different: 262 + 112 mL versus 297 + 99 mL and 227 + 199 mL versus 159 + 73 mL, respectively.
Our study found no significant difference between the Oxylator and BVM when comparing tidal volume delivered to lungs and stomach during ventilation of a simulated unconscious nonintubated patient. More research on BVM use and the Oxylator should be done to validate the American Heart Association's guideline recommendations for ventilating unconscious patients with unprotected airways. Research on gastric dilation during cardiopulmonary resuscitation needs to be done with bench models using manikins that simulate chest excursion, bidirectional airway flow, lung impedance, and gastric compliance.
在心肺复苏期间，对气道无保护的患者进行正压通气可导致胃扩张。
确定在使用成人1000毫升一次性袋阀面罩（BVM）装置和氧气驱动、流量受限的Oxylator EMX复苏器时，输送至肺和胃的气量是否存在显著差异。
我们使用一个实验台模型来模拟气道无保护的患者，该模型由一个插管人体模型、肺模拟器和模拟的下食管括约肌组成，下食管括约肌的开放压力设定为20厘米水柱。使用BVM和Oxylator以口头提示的12次/分钟的频率进行面罩通气。
使用BVM和Oxylator输送至肺和胃的气量无显著差异：分别为262 + 112毫升对297 + 99毫升以及227 + 199毫升对159 + 73毫升。
我们的研究发现，在模拟无意识未插管患者通气期间，比较输送至肺和胃的潮气量时，Oxylator和BVM之间无显著差异。应针对BVM的使用和Oxylator开展更多研究，以验证美国心脏协会关于为气道无保护的无意识患者通气的指南建议。需要使用模拟胸部运动、双向气道气流、肺阻抗和胃顺应性的人体模型，通过实验台模型开展关于心肺复苏期间胃扩张的研究。
