Background and goal of study: The European Resuscitation Council (ERC) has recommended smaller tidal volumes of 500 mL for BLS in order to minimise gastric inflation . The use of a 700 mL paediatric self-inflating bag resulted in tidal volumes of only ∼350 mL and insufficient oxygenation when using room air . In this study we assessed the effects of a new self-inflating bag (1100 mL) on respiratory parameters and blood gases compared to the adult self-inflating bag (1500 mL).
Materials and methods: After approval of the institutional Ethics Committee and written, informed consent, 50 adult patients (ASA 1-2) were randomly allocated to room-air-ventilation without preoxygenation during standardized induction of anaesthesia with either a 1500 mL (n=25) or 1100 mL (n=25) self-inflating bag. Respiratory variables were recorded; blood gas samples were taken before induction of anaesthesia and after 5 min of ventilation.
Results and discussion: When compared with an adult self-inflating bag, the use of the new 1100 mL medium-size bag resulted in significantly (P<0.05) lower tidal volumes per kg bodyweight (8.5±3 vs. 10.7±3 mL kg−1), oxygen saturation (Table 1), and partial pressure of oxygen (Table 1). Carbon dioxide levels were comparable between both self-inflating bags (Table 1). Our results indicate that smaller tidal volumes of about 8.5 mL kg−1 and room-air give with an 1100 mL self-inflating bag may maintain adequate ventilation and oxygenation during BLS.
Conclusion: With regard to the ERC recommendations, the novel 1100 mL self-inflating bag may combine both advantages, adequate ventilatory support and minimised risk of gastric inflation.
1 Airway and Ventilation Management Working Group of the European Resuscitation Council. Guidelines for the basic management of the airway and ventilation during CPR. Resuscitation
2 V. Dörges, C. Sauer, H. Ocker, V. Wenzel, P. Schumucker. Smaller tidal volumes during cardiopulmonary resuscitation: comparison of adult and paediatric self-inflating bags with three different ventilatory devices. Resuscitation
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Resuscitation and emergency medicine