Dietrich P, Graetz K W, Mutzbauer T S
Department of Craniomaxillofacial and Oral Surgery, University Hospital Zurich, Frauenklinikstr 24, CH-8091, Zurich, Switzerland.
Oral Maxillofac Surg. 2013 Sep;17(3):173-9. doi: 10.1007/s10006-012-0351-8. Epub 2012 Aug 7.
Infrequent training of lay rescuers in cardiopulmonary resuscitation may lead to stomach inflation during ventilation of the unsecured airway. This is caused by a pressure loss of the lower oesophageal sphincter (LOSP) after onset of cardiac arrest. To minimise the risk of stomach inflation, the SMART BAG® (SB), a disposable flow-limited bag-valve-mask resuscitator, has been designed. Aim The aim of this study was to evaluate the occurrence of stomach inflation by use of SB in comparison to two other ventilation devices with respect to the ventilation capability.
An Easy Grip® disposable bag-valve-mask resuscitator (EG), an SB and an EG with an interposed T-piece attached to a 0.5 l reservoir bag (EG/R) were compared in a manikin ventilation training setting. Fourteen dentists performed ventilations on a Mini Ventilation Training Analyzer using EG, SB and EG/R with lung compliance (LC) and LOSP being adjusted to 700 ml/kPa and 1.5 kPa (best case) and 500 ml/kPa and 0.5 kPa (worst case) in a randomised order.
Sufficient tidal volumes were obtained by use of all the three test devices regardless of LC or LOSP. No statistical differences were detected between the use of SB and EG/R. Using EG led to statistically larger volumes. Stomach inflation could only be avoided using SB and EG/R at a high LOSP regardless of LC.
Even in the worst case scenario, use of SB and EG/R administered sufficient tidal volumes with a significantly smaller stomach inflation compared to EG. Combination of standard bag-valve devices with a reservoir bag may provide similar protection from gastric inflation as the SMART BAG®.
非专业救援人员心肺复苏培训机会较少，可能导致在未固定气道通气时胃内充气。这是由于心脏骤停后下食管括约肌（LOSP）压力丧失所致。为尽量降低胃内充气风险，设计了一次性流量限制型袋阀面罩复苏器SMART BAG®（SB）。目的本研究旨在比较SB与其他两种通气设备在通气能力方面胃内充气的发生率。
在模拟人通气训练环境中，比较了Easy Grip®一次性袋阀面罩复苏器（EG）、SB以及连接0.5升贮气囊的带T形管的EG（EG/R）。14名牙医在迷你通气训练分析仪上使用EG、SB和EG/R进行通气，将肺顺应性（LC）和LOSP分别随机调整为700毫升/千帕和1.5千帕（最佳情况）以及500毫升/千帕和0.5千帕（最差情况）。
无论LC或LOSP如何，使用所有三种测试设备均能获得足够的潮气量。使用SB和EG/R之间未检测到统计学差异。使用EG导致潮气量在统计学上更大。无论LC如何，只有在高LOSP时使用SB和EG/R才能避免胃内充气。
即使在最差情况下，与EG相比，使用SB和EG/R能提供足够的潮气量，且胃内充气明显减少。标准袋阀设备与贮气囊结合可能提供与SMART BAG®类似的防止胃内充气的保护作用。
