Connors R, Kissoon N, Tiffin N, Frewen T C
Department of Pediatrics, Children's Hospital of Western Ontario, London.
Pediatr Emerg Care. 1993 Apr;9(2):104-7. doi: 10.1097/00006565-199304000-00012.
Self-inflating resuscitators (SIRs) are commonly used to assist ventilation in the newborn. Despite their widespread use, there is limited information available on the functional and physical characteristics of SIRs. We studied five new infant bag-valve units to compare their physical characteristics, including reservoir, accumulator, and dead space volumes (VD), pressure relief mechanism (PRM), inspiratory resistance (RI), and functional mechanics including stroke volume (SV), fraction of delivered oxygen (FDO2), and cycle frequency at -5 degrees C, 20 degrees C, and 49 degrees C, using a test lung apparatus and experienced respiratory therapists. In addition, deficiencies and features that may render them less than ideal were sought. All SIRs met minimum standards for reservoir and accumulator volumes, RI (< 20 cmH2O/L/sec), SV (20-70 ml), and FDO2 (> 90%) as determined by the Canadian Standards Association (CSA) and the American Society for Testing of Materials (ASTM). However, the following deficiencies were noted: 1) MPR and Pulmanex had no PRM (ASTM requirement); 2) MPR could not cycle at -5 degrees C; 3) the VDs for Pulmanex (10 ml) and MPR (15 ml) were high; 4) the CPR connector broke during normal use, and the MPR connector frequently disconnected; 5) the Laerdal expiratory valve was incompetent; and 6) the Laerdal and CPR could be misassembled for use. Our study shows that some commercially available SIRs do not meet all CSA and ASTM standards and may not be ideal in specific clinical situations. The choice of a SIR may be dictated by the clinical situation in which its use is intended.
自动充气式复苏器（SIRs）常用于辅助新生儿通气。尽管其应用广泛，但关于SIRs功能和物理特性的信息有限。我们研究了五种新型婴儿袋阀装置，通过测试肺装置和经验丰富的呼吸治疗师，比较它们在-5℃、20℃和49℃时的物理特性，包括储气囊、蓄能器和死腔容积（VD）、压力释放机制（PRM）、吸气阻力（RI），以及功能力学特性，如潮气量（SV）、输送氧分数（FDO2）和循环频率。此外，还找出了可能使其不够理想的缺陷和特点。所有SIRs均符合加拿大标准协会（CSA）和美国材料与试验协会（ASTM）规定的储气囊和蓄能器容积、RI（<20 cmH2O/L/秒）、SV（20 - 70 ml）和FDO2（>90%）的最低标准。然而，发现了以下缺陷：1）MPR和Pulmanex没有PRM（ASTM要求）；2）MPR在-5℃时无法循环；3）Pulmanex（10 ml）和MPR（15 ml）的VD较高；4）CPR连接器在正常使用时断裂，MPR连接器经常断开；5）Laerdal呼气阀功能不全；6）Laerdal和CPR可能会组装错误以供使用。我们的研究表明，一些市售的SIRs不符合所有CSA和ASTM标准，在特定临床情况下可能并不理想。SIRs的选择可能取决于其预期使用的临床情况。
