在成人心脏骤停模型中，使用Impact Model 730自动转运呼吸机与传统面罩袋阀进行通气和胸外按压的比较。

Comparison of ventilation and cardiac compressions using the Impact Model 730 automatic transport ventilator compared to a conventional bag valve with a facemask in a model of adult cardiopulmonary arrest.

作者信息

Salas Nichole, Wisor Bernadette, Agazio Janice, Branson Richard, Austin Paul N

机构信息

Graduate School of Nursing, Uniformed Services University of the Health Sciences, Silver Spring, MD 20910, United States.

出版信息

Resuscitation. 2007 Jul;74(1):94-101. doi: 10.1016/j.resuscitation.2006.01.023. Epub 2007 Feb 6.

DOI:10.1016/j.resuscitation.2006.01.023

PMID:17287062

Abstract

PURPOSE

To determine the performance of two person CPR on an instrumented manikin by registered nurses using conventional bag valve mask (BVM) ventilation or the Impact Model 730 automatic transport ventilator (Impact 730, Impact Instrumentation, Inc., West Caldwell, NJ) in CPR mode using a face mask.

DESIGN

Randomized crossover quasi-experimental.

SETTING

Laboratory simulation.

SUBJECTS

Twenty-eight registered nurses trained in performing adult cardiopulmonary resuscitation (CPR).

INTERVENTIONS

Basic Life Support was provided by subjects using a conventional bag valve mask (BVM) ventilation or mask ventilation with an automatic transport ventilator, the Impact 730, which incorporates a metronome to facilitate chest compression timing. Subjects alternated performing 4min of CPR using the BVM or Impact 730 to deliver breaths with a mask while the other subject performed compressions.

MEASUREMENTS AND MAIN RESULTS

Flow, volume and pressure were measured using a pneumotachograph and pressure transducer, and ease of use was measured using a 10cm visual analogue scale. There was no statistical or clinical difference between the actual and recommended tidal lung volume (mean+/-S.D.) delivered by the Impact 730 (-120.4+/-91.5ml) versus the BVM (-119.8+/-187.3+/-ml). Ventilation with the BVM resulted in more (137.7+/-143.9ml) air per breath passing through the simulated lower esophageal sphincter compared to the Impact 730 (14.0+/-16.8ml, p<0.05). The reduced mask leak per breath with the Impact 730 (176.1+/-98.3ml) compared to the BVM (367.6+/-337.7ml, p<0.05) is likely to have resulted from the subject being able to manage the mask with two rather than one hand and is reflected in the higher ease of use score on a 10cm visual analogue scale with the Impact 730 (8.06+/-1.35cm) versus the BVM (6.46+/-2.46cm, p<0.05). Subjects tended to deliver slightly more compressions and breaths when using the BVM.

CONCLUSION

Compared to the BVM, the Impact 730 is as effective, easier to use and limits the amount of gas entering the stomach when used during adult CPR in a simulated setting.

摘要

目的

确定注册护士使用传统的袋阀面罩（BVM）通气或Impact Model 730自动转运呼吸机（Impact 730，Impact Instrumentation公司，新泽西州韦斯特考德威尔）在心肺复苏（CPR）模式下通过面罩对配备仪器的人体模型进行双人CPR的效果。

设计

随机交叉准实验。

设置

实验室模拟。

受试者

28名接受过成人心肺复苏（CPR）培训的注册护士。

干预措施

受试者使用传统的袋阀面罩（BVM）通气或使用自动转运呼吸机Impact 730进行面罩通气来提供基础生命支持，Impact 730带有节拍器以方便胸外按压计时。受试者交替使用BVM或Impact 730进行4分钟的CPR，一人使用面罩进行通气，另一人进行按压。

测量指标及主要结果

使用呼吸流速计和压力传感器测量流量、容积和压力，并使用10厘米视觉模拟量表测量易用性。Impact 730（-120.4±91.5毫升）与BVM（-119.8±187.3毫升）实际输送的潮气量与推荐潮气量之间无统计学或临床差异。与Impact 730（14.0±16.8毫升，p<0.05）相比，使用BVM通气时每次呼吸通过模拟下食管括约肌的空气更多（137.7±143.9毫升）。与BVM（367.6±337.7毫升，p<0.05）相比，Impact 730每次呼吸时面罩漏气减少（176.1±98.3毫升），这可能是因为受试者能够用两只手而不是一只手操作面罩，这也反映在Impact 730在10厘米视觉模拟量表上的易用性得分更高（8.06±1.35厘米），而BVM为（6.46±2.46厘米，p<0.05）。使用BVM时，受试者倾向于进行稍多的按压和通气。