Airway management during cardiopulmonary resuscitation—a comparative study of bag–valve–mask, laryngeal mask airway and combitube in a bench model
Gastric inflation and subsequent regurgitation are a potential risk of ventilation during cardiopulmonary resuscitation (CPR). In respect of recent investigations, principal respiratory components such as respiratory system compliance, resistance and lower esophageal sphincter pressure were adapted...
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| Veröffentlicht in: | Resuscitation 1999-06, Vol.41 (1), p.63-69 |
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| creator | Doerges, Volker Sauer, Carsten Ocker, Hartmut Wenzel, Volker Schmucker, Peter |
| description | Gastric inflation and subsequent regurgitation are a potential risk of ventilation during cardiopulmonary resuscitation (CPR). In respect of recent investigations, principal respiratory components such as respiratory system compliance, resistance and lower esophageal sphincter pressure were adapted according to CPR situations. The purpose of our study was to assess lung ventilation and gastric inflation when performing ventilation with bag–valve–mask, laryngeal mask airway, and combitube in a bench model simulating an unintubated cardiac arrest patient. Twenty-one student nurses, without any experience in basic life support measures, ventilated the bench model with all three devices. Mean (±S.D.) gastric inflation with the laryngeal mask airway (seven cases) was significantly lower than with the bag–valve–mask (0.6±0.8
1 vs 3.0±2.1 l min
−1,
P5 l when using the bag–valve–mask, whereas mean (±S.D.) 1-min lung volumes with both laryngeal mask airway and combitube were significantly higher (laryngeal mask airway 15.0±6.6 l, combitube 16.6±6.8 l vs bag–valve–mask 4.8±2.7 l,
P |
| doi_str_mv | 10.1016/S0300-9572(99)00036-2 |
| format | Article |
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1 vs 3.0±2.1 l min
−1,
P<0.01). There was no gastric inflation when ventilation was performed with the combitube. Only seven of 21 volunteers exceeded 1-min lung volumes of >5 l when using the bag–valve–mask, whereas mean (±S.D.) 1-min lung volumes with both laryngeal mask airway and combitube were significantly higher (laryngeal mask airway 15.0±6.6 l, combitube 16.6±6.8 l vs bag–valve–mask 4.8±2.7 l,
P<0.01). The time for insertion was significantly faster with both bag–valve–mask and laryngeal mask airway compared with the combitube (median: bag–valve–mask 22 s, laryngeal mask airway 37 s vs combitube 70 s,
P<0.01). This may tip the scales towards using the laryngeal mask airway during basic life support airway management. In conclusion, our data suggests that both laryngeal mask airway and combitube may be appropriate alternatives for airway management in the first few minutes of CPR.</description><identifier>ISSN: 0300-9572</identifier><identifier>EISSN: 1873-1570</identifier><identifier>DOI: 10.1016/S0300-9572(99)00036-2</identifier><identifier>PMID: 10459594</identifier><identifier>CODEN: RSUSBS</identifier><language>eng</language><publisher>Shannon: Elsevier Ireland Ltd</publisher><subject>Adult ; Airway management ; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; Bag–valve–mask ; Basic life support ; Biological and medical sciences ; Cardiopulmonary Resuscitation - instrumentation ; Combitube ; CPR ; Emergency and intensive cardiocirculatory care. Cardiogenic shock. Coronary intensive care ; Female ; Humans ; Intensive care medicine ; Intubation, Intratracheal ; Laryngeal mask airway ; Laryngeal Masks ; Male ; Manikins ; Masks ; Medical sciences ; Students, Nursing</subject><ispartof>Resuscitation, 1999-06, Vol.41 (1), p.63-69</ispartof><rights>1999 Elsevier Science Ireland Ltd</rights><rights>1999 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c456t-6e230e76a407bf9d4a26dd4dc7fdd9e83759f3bf0641c23bf88d85a5630acff3</citedby><cites>FETCH-LOGICAL-c456t-6e230e76a407bf9d4a26dd4dc7fdd9e83759f3bf0641c23bf88d85a5630acff3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/S0300-9572(99)00036-2$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=1897971$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/10459594$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Doerges, Volker</creatorcontrib><creatorcontrib>Sauer, Carsten</creatorcontrib><creatorcontrib>Ocker, Hartmut</creatorcontrib><creatorcontrib>Wenzel, Volker</creatorcontrib><creatorcontrib>Schmucker, Peter</creatorcontrib><title>Airway management during cardiopulmonary resuscitation—a comparative study of bag–valve–mask, laryngeal mask airway and combitube in a bench model</title><title>Resuscitation</title><addtitle>Resuscitation</addtitle><description>Gastric inflation and subsequent regurgitation are a potential risk of ventilation during cardiopulmonary resuscitation (CPR). In respect of recent investigations, principal respiratory components such as respiratory system compliance, resistance and lower esophageal sphincter pressure were adapted according to CPR situations. The purpose of our study was to assess lung ventilation and gastric inflation when performing ventilation with bag–valve–mask, laryngeal mask airway, and combitube in a bench model simulating an unintubated cardiac arrest patient. Twenty-one student nurses, without any experience in basic life support measures, ventilated the bench model with all three devices. Mean (±S.D.) gastric inflation with the laryngeal mask airway (seven cases) was significantly lower than with the bag–valve–mask (0.6±0.8
1 vs 3.0±2.1 l min
−1,
P<0.01). There was no gastric inflation when ventilation was performed with the combitube. Only seven of 21 volunteers exceeded 1-min lung volumes of >5 l when using the bag–valve–mask, whereas mean (±S.D.) 1-min lung volumes with both laryngeal mask airway and combitube were significantly higher (laryngeal mask airway 15.0±6.6 l, combitube 16.6±6.8 l vs bag–valve–mask 4.8±2.7 l,
P<0.01). The time for insertion was significantly faster with both bag–valve–mask and laryngeal mask airway compared with the combitube (median: bag–valve–mask 22 s, laryngeal mask airway 37 s vs combitube 70 s,
P<0.01). This may tip the scales towards using the laryngeal mask airway during basic life support airway management. In conclusion, our data suggests that both laryngeal mask airway and combitube may be appropriate alternatives for airway management in the first few minutes of CPR.</description><subject>Adult</subject><subject>Airway management</subject><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</subject><subject>Bag–valve–mask</subject><subject>Basic life support</subject><subject>Biological and medical sciences</subject><subject>Cardiopulmonary Resuscitation - instrumentation</subject><subject>Combitube</subject><subject>CPR</subject><subject>Emergency and intensive cardiocirculatory care. Cardiogenic shock. Coronary intensive care</subject><subject>Female</subject><subject>Humans</subject><subject>Intensive care medicine</subject><subject>Intubation, Intratracheal</subject><subject>Laryngeal mask airway</subject><subject>Laryngeal Masks</subject><subject>Male</subject><subject>Manikins</subject><subject>Masks</subject><subject>Medical sciences</subject><subject>Students, Nursing</subject><issn>0300-9572</issn><issn>1873-1570</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1999</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkc9u1DAQxi0EokvhEUA-IAQSATuJ4_hUVRX_pEoc6N2a2JPFkNiLnSzaW98BDjxfnwSnWQE3TuORft_M-PsIeczZK8548_oTqxgrlJDlc6VeMMaqpijvkA1vZVVwIdldsvmDnJAHKX1ZIKHkfXLCWS2UUPWG_Dp38Tsc6Agetjiin6ido_NbaiBaF3bzMAYP8UAjpjkZN8Hkgr-5_gnUhHEHMfd7pGma7YGGnnawvbn-sYdhj7mOkL6-pEPW-y3CQJeewroSvF1GdG6aO6TOU6AdevOZjsHi8JDc62FI-OhYT8nV2zdXF--Ly4_vPlycXxamFs1UNFhWDGUDNZNdr2wNZWNtbY3srVXYVlKovup61tTclPnRtrYVIJqKgen76pQ8W8fuYvg2Y5r06JLBYQCPYU66UUqJlqsMihU0MaQUsde76Mb8Mc2ZXhLRt4noxW6tlL5NRJdZ9-S4YO5GtP-o1ggy8PQIQDIw9BG8cekv1yqpJM_Y2YphNmPvMOocRrYLrYtoJm2D-88lvwEzx68Q</recordid><startdate>19990601</startdate><enddate>19990601</enddate><creator>Doerges, Volker</creator><creator>Sauer, Carsten</creator><creator>Ocker, Hartmut</creator><creator>Wenzel, Volker</creator><creator>Schmucker, Peter</creator><general>Elsevier Ireland Ltd</general><general>Elsevier</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>19990601</creationdate><title>Airway management during cardiopulmonary resuscitation—a comparative study of bag–valve–mask, laryngeal mask airway and combitube in a bench model</title><author>Doerges, Volker ; Sauer, Carsten ; Ocker, Hartmut ; Wenzel, Volker ; Schmucker, Peter</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c456t-6e230e76a407bf9d4a26dd4dc7fdd9e83759f3bf0641c23bf88d85a5630acff3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1999</creationdate><topic>Adult</topic><topic>Airway management</topic><topic>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</topic><topic>Bag–valve–mask</topic><topic>Basic life support</topic><topic>Biological and medical sciences</topic><topic>Cardiopulmonary Resuscitation - instrumentation</topic><topic>Combitube</topic><topic>CPR</topic><topic>Emergency and intensive cardiocirculatory care. Cardiogenic shock. Coronary intensive care</topic><topic>Female</topic><topic>Humans</topic><topic>Intensive care medicine</topic><topic>Intubation, Intratracheal</topic><topic>Laryngeal mask airway</topic><topic>Laryngeal Masks</topic><topic>Male</topic><topic>Manikins</topic><topic>Masks</topic><topic>Medical sciences</topic><topic>Students, Nursing</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Doerges, Volker</creatorcontrib><creatorcontrib>Sauer, Carsten</creatorcontrib><creatorcontrib>Ocker, Hartmut</creatorcontrib><creatorcontrib>Wenzel, Volker</creatorcontrib><creatorcontrib>Schmucker, Peter</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Resuscitation</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Doerges, Volker</au><au>Sauer, Carsten</au><au>Ocker, Hartmut</au><au>Wenzel, Volker</au><au>Schmucker, Peter</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Airway management during cardiopulmonary resuscitation—a comparative study of bag–valve–mask, laryngeal mask airway and combitube in a bench model</atitle><jtitle>Resuscitation</jtitle><addtitle>Resuscitation</addtitle><date>1999-06-01</date><risdate>1999</risdate><volume>41</volume><issue>1</issue><spage>63</spage><epage>69</epage><pages>63-69</pages><issn>0300-9572</issn><eissn>1873-1570</eissn><coden>RSUSBS</coden><abstract>Gastric inflation and subsequent regurgitation are a potential risk of ventilation during cardiopulmonary resuscitation (CPR). In respect of recent investigations, principal respiratory components such as respiratory system compliance, resistance and lower esophageal sphincter pressure were adapted according to CPR situations. The purpose of our study was to assess lung ventilation and gastric inflation when performing ventilation with bag–valve–mask, laryngeal mask airway, and combitube in a bench model simulating an unintubated cardiac arrest patient. Twenty-one student nurses, without any experience in basic life support measures, ventilated the bench model with all three devices. Mean (±S.D.) gastric inflation with the laryngeal mask airway (seven cases) was significantly lower than with the bag–valve–mask (0.6±0.8
1 vs 3.0±2.1 l min
−1,
P<0.01). There was no gastric inflation when ventilation was performed with the combitube. Only seven of 21 volunteers exceeded 1-min lung volumes of >5 l when using the bag–valve–mask, whereas mean (±S.D.) 1-min lung volumes with both laryngeal mask airway and combitube were significantly higher (laryngeal mask airway 15.0±6.6 l, combitube 16.6±6.8 l vs bag–valve–mask 4.8±2.7 l,
P<0.01). The time for insertion was significantly faster with both bag–valve–mask and laryngeal mask airway compared with the combitube (median: bag–valve–mask 22 s, laryngeal mask airway 37 s vs combitube 70 s,
P<0.01). This may tip the scales towards using the laryngeal mask airway during basic life support airway management. In conclusion, our data suggests that both laryngeal mask airway and combitube may be appropriate alternatives for airway management in the first few minutes of CPR.</abstract><cop>Shannon</cop><pub>Elsevier Ireland Ltd</pub><pmid>10459594</pmid><doi>10.1016/S0300-9572(99)00036-2</doi><tpages>7</tpages></addata></record> |
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| ispartof | Resuscitation, 1999-06, Vol.41 (1), p.63-69 |
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| language | eng |
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| source | MEDLINE; Access via ScienceDirect (Elsevier) |
| subjects | Adult Airway management Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy Bag–valve–mask Basic life support Biological and medical sciences Cardiopulmonary Resuscitation - instrumentation Combitube CPR Emergency and intensive cardiocirculatory care. Cardiogenic shock. Coronary intensive care Female Humans Intensive care medicine Intubation, Intratracheal Laryngeal mask airway Laryngeal Masks Male Manikins Masks Medical sciences Students, Nursing |
| title | Airway management during cardiopulmonary resuscitation—a comparative study of bag–valve–mask, laryngeal mask airway and combitube in a bench model |
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