ABSTRACTS
It’s in The Bag: Tidal Volumes in Adult and Pediatric Bag-Valve MasksAuthor: Benjamin Dafilou | | Associate Authors: Daniel Schwester | Nathan Ruhl | Andreia Marques-Baptista
Introduction A bag-valve mask (BVM) is a life-saving device used by all levels of healthcare professionals during resuscitative care. We focus most of our time optimizing the patient’s position, firmly securing the mask, and frequency of ventilations. However, despite our best efforts to control these factors, we may still be precipitating harm to the patient. Multiple studies have shown the tidal volumes typically delivered by the adult BVM are often higher than recommended for lung-protective ventilation protocols. In this study, we measure and compare the ventilation parameters delivered by the adult and pediatric BVM ventilators. Methods A RespiTrainer Advance® adult mannequin was used to simulate a patient. Healthcare providers were directed to manually ventilate an intubated mannequin for two minutes using adult and pediatric sized BVMs. Tidal volume, minute ventilation, peak pressure, and respiration rate were recorded. Results The adult BVM provided a mean tidal volume of 807.7 mL vs the pediatric BVM providing 630.7 mL, both of which exceeded the upper threshold of 560 mL of tidal volume necessary for lung protective ventilation of an adult male with an ideal body weight of 70 kg. The adult BVM exceeded this threshold by 44.2% vs the pediatric BVMs (12.6%) with 93% of participants exceeding the maximum threshold with the adult BVM and 82.3% exceeding it with the pediatric BVM. Conclusion The pediatric BVM in our study provided far more consistent and appropriate ventilation parameters for adult patients compared to an adult BVM, but still exceeded the upper limits of lung protective ventilation parameters. The results of this study highlight the potential dangers in using an adult BVM due to increased risk of pulmonary barotrauma. These higher tidal volumes can contribute to lung injury. This study confirms that smaller BVMs may provide safer ventilatory parameters. Future studies should focus on patient-centered outcomes with BVM.
|
