Giffen P R, Hope C E
Department of Anaesthesia, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada.
Ann Emerg Med. 1991 Mar;20(3):262-6. doi: 10.1016/s0196-0644(05)80936-9.
The objective was to design a prototype tube-valve-mask ventilator that would permit relatively inexperienced operators to provide adequate emergency artificial ventilation, namely, adequate ventilatory volumes and a high oxygen and low carbon dioxide delivery.
The tube-valve-mask ventilator is powered by the exhaled air of the operator and uses a tube to act as an oxygen reservoir (1,300 mL) that is filled between breaths. Mouth-to-mouth breathing was the standard against which the tube-valve-mask ventilator and the other accepted methods of mouth-to-mask and bag-valve-mask were assessed.
Comparison studies were conducted during simulated two-person CPR using a training mannikin equipped to measure ventilation volume and delivered oxygen and carbon dioxide concentrations.
Seventeen volunteer first-year nursing students were used as operators.
The order in which the pairs of operators performed each of the techniques was randomized.
The ventilation volume and the percentage of oxygen and carbon dioxide delivered by each technique were as follows (mean +/- SD): Mouth-to mouth (760 +/- 290 mL, 17 +/- 1% O2, 3.4 +/- 0.4% CO2), mouth-to-mask (910 +/- 350 mL, 41 +/- 8% O2, 2.5 +/- 0.4% CO2), bag-valve-(soft) mask (550 +/- 230 mL, 94 +/- 3% O2, 0.03 +/- 0.02% CO2), bag-valve-(rigid) mask (560 +/- 300 mL, 96 +/- 3% O2, 0.03 +/- 0.02% CO2), and tube-valve-mask (860 +/- 290 mL, 91 +/- 7% O2, 0.2 +/- 0.2% CO2).
In the hands of relatively inexperienced operators, mouth-to-mouth, mouth-to-mask, and tube-valve-mask techniques provide adequate ventilation volumes to a mannikin. This was not the case with the bag-valve-mask systems (800 mL; P = .05 by t test). Of the systems that provide adequate ventilation volume, the tube-valve-mask appears, superior in that higher oxygen and lower carbon dioxide concentrations can also be obtained (P = .05 by paired t test).
设计一种原型管阀面罩通气机，使经验相对不足的操作人员能够进行充分的紧急人工通气，即提供足够的通气量以及高氧低二氧化碳输送。
管阀面罩通气机由操作人员呼出的空气提供动力，并使用一根管子作为氧气储存器（1300毫升），在呼吸间隙进行填充。以口对口呼吸作为标准，对管阀面罩通气机以及其他公认的口对面罩和袋阀面罩方法进行评估。
在使用配备了测量通气量以及输送氧气和二氧化碳浓度装置的训练人体模型进行模拟双人心肺复苏期间进行比较研究。
17名一年级护理专业志愿者学生作为操作人员。
操作人员对每种技术的操作顺序是随机的。
每种技术的通气量以及输送氧气和二氧化碳的百分比如下（均值±标准差）：口对口（760±290毫升，17±1%氧气，3.4±0.4%二氧化碳），口对面罩（910±350毫升，41±8%氧气，2.5±0.4%二氧化碳），袋阀（软质）面罩（550±230毫升，94±3%氧气，0.03±0.02%二氧化碳），袋阀（硬质）面罩（560±300毫升，96±3%氧气，0.03±0.02%二氧化碳），以及管阀面罩（860±290毫升，91±7%氧气，0.2±0.2%二氧化碳）。
在经验相对不足的操作人员手中，口对口、口对面罩和管阀面罩技术能够为人体模型提供足够的通气量。袋阀面罩系统则不然（800毫升；t检验，P = 0.05）。在能够提供足够通气量的系统中，管阀面罩似乎更具优势，因为它还能获得更高的氧气浓度和更低的二氧化碳浓度（配对t检验，P = 0.05）。
