title: Comparison of the Mapleson C system and adult and paediatric self-inflating bags for delivering guideline-consistent ventilation during simulated adult cardiopulmonary resuscitation.
abstract: There is a discrepancy between resuscitation teaching and witnessed clinical practice. Furthermore, deleterious outcomes are associated with hyperventilation. We therefore conducted a manikin-based study of a simulated cardiac arrest to evaluate the ability of three ventilating devices to provide guideline-consistent ventilation. Mean (SD) minute ventilation was reduced with the paediatric self-inflating bag (7.0 (3.2) l.min⁻¹) compared with the Mapleson C system (9.8 (3.5) l.min⁻¹) and adult self-inflating bag (9.7 (4.2) l.min⁻¹ ; p = 0.003). Tidal volume was also lower with the paediatric self-inflating bag (391 (52) ml) compared with the others (582 (87) ml and 625 (103) ml, respectively; p < 0.001), as was peak airway pressure (14.5 (5.2) cmH₂O vs 20.7 (9.0) cmH₂O and 30.3 (11.4) cmH₂O, respectively; p < 0.001). Participants hyperventilated patients' lungs in simulated cardiac arrest with all three devices. The paediatric self-inflating bag delivered the most guideline-consistent ventilation. Its use in adult cardiopulmonary resuscitation may ensure delivery of more guideline-consistent ventilation in patients with tracheal intubation.
authors.affiliation: Department of Anaesthesia and Intensive Care Medicine, Queen's Hospital, Barking Havering and Redbridge NHS Trust, Romford, Essex, UK. petersherren@gmail.com
authors.forename: P B
authors.initials: PB
authors.lastname: Sherren
authors.forename: A
authors.initials: A
authors.lastname: Lewinsohn
authors.forename: T
authors.initials: T
authors.lastname: Jovaisa
authors.forename: D S
authors.initials: DS
authors.lastname: Wijayatilake
mesh_terms: D000328:Adult; D000403:Airway Resistance / Q000502:physiology; D016887:Cardiopulmonary Resuscitation / Q000295:instrumentation* / Q000592:standards; D002648:Child; D002983:Clinical Competence; D019983:Guideline Adherence; D006323:Heart Arrest / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D008348:Manikins; D017410:Practice Guidelines as Topic; D056152:Respiratory Rate / Q000502:physiology; D013990:Tidal Volume / Q000502:physiology; D012122:Ventilators, Mechanical