Updike G, Mosesso V N, Auble T E, Delgado E
Alumni Association Summer Research Fellowship, University of Pittsburgh School of Medicine, PA 15261, USA. gmust2+@pitt.edu
Prehosp Emerg Care. 1998 Jan-Mar;2(1):52-5. doi: 10.1080/10903129808958840.
To determine whether there were differences in tidal volume (Vt), minute volume (MV), average mask leak per breath (ML), gastric insufflation (GI), and peak airway pressure (PAP) when ventilating a nonintubated mannikin with a bag-valve-mask (BV), manually triggered ventilator (MTV), and automated ventilator (AV). The authors' hypothesis was that there would be no differences among the devices for any of these variables.
This was a prospective in-vitro experimental model. A convenience sample of 19 emergency medical technicians (EMTs) ventilated a nonintubated mannikin-mechanical test lung model with the BV, MTV (flow rate 40 L/min; pressure relief 55 cm H2O), and AV (800 mL/breath; rate 12). Each subject, blinded to volume and pressure gauges, used each device for 2 minutes at both normal (0.1 cm H2O) and poor (0.04 cm H2O) compliances. Vt, MV, GI, and PAP were measured directly and ML was calculated. A survey was issued to the EMTs who participated in the study. Data were analyzed with repeated-measures ANOVA and the Bonferroni-Dunn multiple comparison test with alpha set at 0.05.
At the normal compliance, PAP was higher for the BV than the MTV (p = 0.0001) and AV (p < 0.0001). MV was also greater with the BV than with the AV (p = 0.001). PAP was also higher at the poor compliance with the BV than with the MTV and AV (p = 0.008 and 0.013, respectively). The BV had a higher GI at this compliance (p < 0.0001) and a higher ML than the AV (p = 0.002).
All three devices delivered similar volumes when used by EMTs, but the BV was associated with higher PAP, ML, and GI.
确定使用袋阀面罩（BV）、手动触发呼吸机（MTV）和自动呼吸机（AV）对未插管人体模型进行通气时，潮气量（Vt）、分钟通气量（MV）、每次呼吸的平均面罩漏气量（ML）、胃充气量（GI）和气道峰值压力（PAP）是否存在差异。作者的假设是，对于这些变量中的任何一个，不同设备之间均无差异。
这是一个前瞻性体外实验模型。选取19名急救医疗技术员（EMT）作为便利样本，使用BV、MTV（流速40L/分钟；压力释放55cmH₂O）和AV（800mL/次呼吸；频率12次/分钟）对未插管的人体模型 - 机械测试肺模型进行通气。每位受试者在不知道容量和压力计数值的情况下，在正常顺应性（0.1cmH₂O）和较差顺应性（0.04cmH₂O）条件下，分别使用每种设备2分钟。直接测量Vt、MV、GI和PAP，并计算ML。对参与研究的EMT进行了一项调查。数据采用重复测量方差分析以及α设定为0.05的Bonferroni-Dunn多重比较检验进行分析。
在正常顺应性条件下，BV的PAP高于MTV（p = 0.0001）和AV（p < 0.0001）。BV的MV也高于AV（p = 0.001）。在较差顺应性条件下，BV的PAP也高于MTV和AV（分别为p = 0.008和0.013）。在此顺应性条件下，BV的GI更高（p < 0.0001），且ML高于AV（p = 0.002）。
EMT使用这三种设备时输送的气量相似，但BV与更高的PAP、ML和GI相关。
