title: Evaluation of manual resuscitators used in ICUs in Brazil.
abstract: OBJECTIVE
  To evaluate the performance of manual resuscitators (MRs) used in Brazil in accordance with international standards.
  
  
  METHODS
  Using a respiratory system simulator, four volunteer physiotherapists employed eight MRs (five produced in Brazil and three produced abroad), which were tested for inspiratory and expiratory resistance of the patient valve; functioning of the pressure-limiting valve; and tidal volume (VT) generated when the one-handed and two-handed techniques were used. The tests were performed and analyzed in accordance with the American Society for Testing and Materials (ASTM) F920-93 criteria.
  
  
  RESULTS
  Expiratory resistance was greater than 6 cmH2O . L-1 . s-1 in only one MR. The pressure-limiting valve, a feature of five of the MRs, opened at low pressures (< 17 cmH2O), and the maximal pressure was 32.0-55.9 cmH2O. Mean VT varied greatly among the MRs tested. The mean VT values generated with the one-handed technique were lower than the 600 mL recommended by the ASTM. In the situations studied, mean VT was generally lower from the Brazilian-made MRs that had a pressure-limiting valve.
  
  
  CONCLUSIONS
  The resistances imposed by the patient valve met the ASTM criteria in all but one of the MRs tested. The pressure-limiting valves of the Brazilian-made MRs usually opened at low pressures, providing lower VT values in the situations studied, especially when the one-handed technique was used, suggesting that both hands should be used and that the pressure-limiting valve should be closed whenever possible.
authors: University of São Paulo, School of Medicine, São Paulo, Brazil.
authors: Tatiana de Arruda
authors: Tde A
authors: Ortiz
authors: Germano
authors: G
authors: Forti
authors: Márcia Souza
authors: MS
authors: Volpe
authors: Marcelo do Amaral
authors: Mdo A
authors: Beraldo
authors: Marcelo Britto Passos
authors: MB
authors: Amato
authors: Carlos Roberto Ribeiro
authors: CR
authors: Carvalho
authors: Mauro Roberto
authors: MR
authors: Tucci
mesh_terms: D001938:Brazil; D057186:Comparative Effectiveness Research / Q000379:methods; D003198:Computer Simulation / Q000592:standards; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D015588:Observer Variation; D015656:Respiratory Mechanics / Q000502:physiology; D012151:Resuscitation / Q000295:instrumentation*; D013990:Tidal Volume; D012122:Ventilators, Mechanical / Q000592:standards / Q000706:statistics & numerical data*