Karolinska Institutet, Department of Clinical Science and Education, Södersjukhuset, Stockholm, Sweden.
Scand J Trauma Resusc Emerg Med. 2010 Sep 14;18:49. doi: 10.1186/1757-7241-18-49.
For healthcare providers in the prehospital setting, bag-valve mask (BVM) ventilation could be as efficacious and safe as endotracheal intubation. To facilitate the evaluation of efficacious ventilation, capnographs have been further developed into small and convenient devices able to provide end- tidal carbon dioxide (ETCO2). The aim of this study was to investigate whether a new portable device (EMMA™) attached to a ventilation mask would provide ETCO2 values accurate enough to confirm proper BVM ventilation.
A prospective observational trial was conducted in a single level-2 centre. Twenty-two patients under general anaesthesia were manually ventilated. ETCO2 was measured every five minutes with the study device and venous PCO2 (PvCO2) was simultaneously measured for comparison. Bland- Altman plots were used to compare ETCO2, and PvCO2.
The patients were all hemodynamically and respiratory stable during anaesthesia. End-tidal carbon dioxide values were corresponding to venous gases during BVM ventilation under optimal conditions. The bias, the mean of the differences between the two methods (device versus venous blood gases), for time points 1-4 ranges from -1.37 to -1.62.
The portable device, EMMA™ is suitable for determining carbon dioxide in expired air (kPa) as compared to simultaneous samples of PvCO2. It could therefore, be a supportive tool to asses the BVM ventilation in the demanding prehospital and emergency setting.
对于院前环境中的医疗保健提供者来说，球囊面罩通气（BVM）可能与气管插管一样有效且安全。为了便于评估有效的通气，呼末二氧化碳描记器进一步发展成为能够提供潮气末二氧化碳（ETCO2）的小型便捷设备。本研究旨在探讨一种新的便携式设备（EMMA™）连接到通气面罩是否能够提供足够准确的 ETCO2 值以确认 BVM 通气是否正确。
在一个单一的 2 级中心进行了前瞻性观察性试验。22 名全身麻醉下的患者进行手动通气。使用研究设备每 5 分钟测量一次 ETCO2，并同时测量静脉 PCO2（PvCO2）进行比较。Bland- Altman 图用于比较 ETCO2 和 PvCO2。
在麻醉期间，所有患者的血流动力学和呼吸均稳定。在最佳条件下进行 BVM 通气时，潮气末二氧化碳值与静脉血气相对应。1-4 点的偏差（两种方法之间差值的平均值，即设备与静脉血气）的范围从-1.37 到-1.62。
便携式设备 EMMA™ 适合用于确定呼出空气中的二氧化碳（kPa）与同时采集的 PvCO2 相比。因此，它可以成为评估院前和紧急环境中 BVM 通气的辅助工具。
