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European Society of Anaesthesiologists; 8th Annual Meeting with the Austrian International Congress; Vienna, Austria, 1-4 April 2000

Optimization of tidal volumes - a new approach for good ventilation and less risk of gastric inflation during basic life support (BLS)?

Dörges, V.; Ocker, H.; Hagelberg, S.; Schmucker, P.

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European Journal of Anaesthesiology: 2000 - Volume 17 - Issue - p 174-175
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Abstract A-572

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 [1]. 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 [2]. 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.

Table 1
Table 1:
Blood gases before induction of anaesthesia and after 5 min of ventilation with both self-inflating bags and room-air

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.

References:

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 1996; 31: 187-200
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 in press.

Section Description

The abstracts published in this supplement have been typeset from camera-ready copies prepared by the authors. Every effort has been made to reproduce faithfully the abstracts as submitted. However, no responsibility is assumed by the organisers for any injury and/or damage to persons or property as a matter of products liability, negligence or otherwise, or from any use or operation of methods, products, instructions or ideas contained in the material herein. Because of the rapid advances in medical sciences, we recommend that independent verification of diagnoses and drug doses should be made.

Resuscitation and emergency medicine

© 2000 European Society of Anaesthesiology