Morin François, Polard Laura, Fresnel Emeline, Richard Mathéo, Schmit Hugo, Martin-Houitte Clarisse, Cordioli Ricardo Luiz, Lebret Marius, Mercat Alain, Beloncle François, Savary Dominique, Richard Jean-Christophe, Lesimple Arnaud
Department of Emergency Medicine, University Hospital of Angers, Angers, France.
Vent'Lab, University Hospital of Angers, Angers, France.
Resusc Plus. 2024 May 23;19:100663. doi: 10.1016/j.resplu.2024.100663. eCollection 2024 Sep.
There is a lack of bench systems permitting to evaluate ventilation devices in the specific context of cardiac arrest.
The objective of the study is to assess if a new physiological manikin may permit to evaluate the performances of medical devices dedicated to ventilation during cardiopulmonary resuscitation (CPR).
Specific CPR-related features required to reproduce realistic ventilation were implemented into the SAM (Sarthe Anjou Mayenne) manikin. In the first place, the manikin ability to mimic ventilation during CPR was assessed and compared to real-life tracings of airway pressure, flow and capnogram from three out of hospital cardiac arrest (OHCA) patients. In addition, to illustrate the interest of this manikin, ventilation was evaluated during mechanical continuous chest compressions with two devices dedicated to CPR: the Boussignac cardiac arrest device (B-card - Vygon; Ecouen France) and the Impedance Threshold Device (ITD - Zoll; Chelmsford, MA).
The SAM manikin enabled precise replication of ventilation tracings as observed in three OHCA patients during CPR, and it allowed for comparison between two distinct ventilation devices. B-card generated a mean, maximum and minimum intrathoracic pressure of 6.3 (±0.1) cmHO, 18.9 (±1.1) cmHO and -0.3 (±0.2) cmHO respectively; while ITD generated a mean, maximum and minimum intrathoracic pressure of -1.6 (±0.0) cmHO, 5.7 (±0.1) cmHO and -4.8 (±0.1) cmHO respectively during CPR. B-card allowed to increase passive ventilation compared to the ITD which resulted in a dramatic limitation of passive ventilation.
The SAM manikin is an innovative model integrating specific physiological features that permit to accurately evaluate and compare ventilation devices during CPR.
缺乏能够在心脏骤停的特定情况下评估通气设备的实验台系统。
本研究的目的是评估一种新型生理模拟人是否能够评估用于心肺复苏（CPR）期间通气的医疗设备的性能。
将重现逼真通气所需的特定CPR相关特征应用于SAM（萨尔特-安茹-马耶讷）模拟人。首先，评估模拟人在CPR期间模拟通气的能力，并与三名院外心脏骤停（OHCA）患者的气道压力、流量和二氧化碳波形图的实际记录进行比较。此外，为了说明这种模拟人的实用性，使用两种用于CPR的设备在机械持续胸外按压期间评估通气：布西尼亚克心脏骤停设备（B-card - 维贡公司；法国埃库昂）和阻抗阈值设备（ITD - 卓尔公司；美国马萨诸塞州切尔姆斯福德）。
SAM模拟人能够精确复制CPR期间三名OHCA患者观察到的通气记录，并且能够对两种不同的通气设备进行比较。B-card产生的平均、最大和最小胸内压分别为6.3（±0.1）cmH₂O、18.9（±1.1）cmH₂O和 -0.3（±0.2）cmH₂O；而ITD在CPR期间产生的平均、最大和最小胸内压分别为 -1.6（±0.0）cmH₂O、5.7（±0.1）cmH₂O和 -4.8（±0.1）cmH₂O。与ITD相比，B-card能够增加被动通气，而ITD导致被动通气显著受限。
SAM模拟人是一种创新模型，整合了特定的生理特征，能够在CPR期间准确评估和比较通气设备。
