Kim Jong Won, Park Sang O, Lee Kyeong Ryong, Hong Dae Young, Baek Kwang Je
Department of Emergency Medicine, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Republic of Korea.
Emerg Med Int. 2020 Apr 24;2020:5296519. doi: 10.1155/2020/5296519. eCollection 2020.
The aim of this study was to test whether Amflow® (a newly designed portable ventilation feedback device) can assist rescuers in delivering target tidal volume ( ) and respiration rate (RR) during self-inflating bag (SB) ventilations in various clinical scenarios.
This was a simulation study with a prospective cross-over design. A total of 40 trained participants who underwent training for SB ventilation were recruited. Using a SB with or without Amflow® alternately, participants delivered ventilations to test lungs connected to a gas flow analyser in each of three different scenarios: acute respiratory distress syndrome (ARDS; 315-385 ml ranges for 350 ml target , with 20 breaths/min); cardiopulmonary resuscitation (CPR; 450-550 ml ranges for 500 ml target with 10 breaths/min); and adult head trauma (630-770 ml ranges for 700 ml target with 15 breaths/min).
The feedback group (SB with Amflow®) demonstrated a significantly higher percentage of delivering the appropriate ranges than the no-feedback group for both ARDS (58.6% versus 23.5%, respectively) and CPR (85.4% versus 41.0%, respectively) (all < 0.05). However, there was no significant difference between the two groups in the percentage of delivering the appropriate ranges in head trauma patients (65.9% versus 68.3%, respectively; =0.092). In all three scenarios, a higher percentage of target RR delivered was achieved in the feedback group (88.3%, 99.2%, and 96.3%, respectively) compared with the no-feedback group (5.8%, 12.5%, and 10.0%, respectively) (all < 0.05).
The Amflow® device could be useful for rescuers in delivering SB ventilation with appropriate and RR simultaneously in various critical situations, except for clinical cases that demand greater delivered .
本研究旨在测试Amflow®(一种新设计的便携式通气反馈设备)能否在各种临床场景下,协助救援人员在使用自动充气式气囊(SB)进行通气时达到目标潮气量( )和呼吸频率(RR)。
这是一项采用前瞻性交叉设计的模拟研究。共招募了40名接受过SB通气培训的参与者。参与者交替使用带有或不带有Amflow®的SB,在三种不同场景下向连接气流分析仪的测试肺进行通气:急性呼吸窘迫综合征(ARDS;目标潮气量350ml,范围为315 - 385ml,呼吸频率20次/分钟);心肺复苏(CPR;目标潮气量500ml,范围为450 - 550ml,呼吸频率10次/分钟);以及成人头部创伤(目标潮气量700ml,范围为630 - 770ml,呼吸频率15次/分钟)。
对于ARDS(分别为58.6%和23.5%)和CPR(分别为85.4%和41.0%),反馈组(使用带有Amflow®的SB)达到适当 范围的百分比显著高于无反馈组(均P < 0.05)。然而,在头部创伤患者中,两组达到适当 范围的百分比无显著差异(分别为65.9%和68.3%;P = 0.092)。在所有三种场景中,与无反馈组(分别为5.8%、12.5%和10.0%)相比,反馈组达到目标RR的百分比更高(分别为88.3%、99.2%和96.3%)(均P < 0.05)。
除了需要更大潮气量的临床病例外,Amflow®设备对于救援人员在各种危急情况下同时进行适当潮气量 和RR的SB通气可能有用。