The Science Journal of the American Association for Respiratory Care

1998 OPEN FORUM Abstracts

Delivered Oxygen Concentration and Work of Breathing when Spontaneously Breathing through Disposable Manual Resuscitator Bags.

Mark Rogers, BS, RCP, RRT Randy Scott, BS, RCP, RRT Thomas Malinowski, BS, RCP, RRT. Department of Respiratory Care, Loma Linda University Medical Center, Loma Linda, California

Introduction: The purpose of this bench study was to evaluate delivered oxygen (FDO_{2}) and imposed work of breathing (WOB) during spontaneous breathing in a cohort of disposable manual resuscitator bags (MRB). Methods: We evaluated five infarit, nine pediatric and eight adult MRBs. Oxygen flow into each MRB was set at 15 LPM. Reservoirs were fully extended (when applicable). A dual chamber test lung was modified to simulate spontaneous breathing. A mechanical ventitator powered one side of the test lung simulating spontaneous breathing in the other lung. The test lung compliance was set at 0.1 mL/cmH_{2}O. Age specific parameters were used: Infant: f = 30, Vt = 70mL, Ti = .6 seconds, ETT = 3.5mm; Pediatric: f = 18, Vt = 200mL, Ti = .95 seconds, ETT = 5.0mm; Adult: f = 10, Vt = 600 mL, Ti = 1.4 seconds, ETT = 7.0mm. The FDO_{2}s were allowed to stabilize and were measured at the endotracheal tube connector using a Perkin-Elmer 1100 Medical Gas Analyzer. Work of breathing measurements were taken from a ten breath average and were obtained using the Ventrak 1500 (Novametrics Medical Systems).

Results: (See table) Infant and pediatric MRBs that employed a one-way valve in the exhalation valve yielded a significantly different (p < 0.005, t-test) FDO_{2} and WOB than those MRBs that do not use a one-way valve. In the adult group, only the FDO_{2} was significantly different (p < 0.005, t-test) in those MRBs that employed the one-way valve.

MRB FDO_{2} WOB Valve

(J/L) Type

Vital Signs Baby Blue - .23 .0285 none

Infant

Simms - Infant .34 .0457 none

Life Designs System Pulmanex .75 .0648 none

- Infant

Ambu Spur - Pediatric/Infant .96 .1409 one-way

Nellcor PB DMR2 - Infant .98 .1367 one-way

Vital Signs Pedi Blue (tail .22 .1563 none

reservoir) - Pediatric

Vital Signs Pedi Blue (neck .22 .1581 none

reservoir) - Pediatric

Simms - Pediatric (latex) .57 .2881 none

Hudson RCI Life Saver - .59 .1544 none

Pediatric

Simms - Pediatric .73 .319 none

Life Designs System Pulmanex .84 .3235 none

- Pediatric

Nellcor PB DMR2 - Pediatric .99 .3041 one-way

Kirk Specialty Systems CapnoFlo .99 .4467 one-way

- Pediatric

Ambu Spur - Pediatric/Infant 1.0 .3681 one-way

Hudson RCI Life Saver - Adult .52 .3435 none

Life Designs System Pulmanex - .66 .6949 none

Adult

Respironics BagEasy - Adult .75 .5084 none

Simms - Adult .78 .7146 none

Vital Signs Adult .85 .8749 none

Kirk Specialty Systems CapnoFlo .93 .8543 one-way

- Adult

Ambu Spur - Adult .98 .5878 one-way

Nellcor PB DMR2 - Adult .98 .614 one-way

Conclusion: MRBs with an expiratory one-way valve yield higher FDO_{2}s than MRBs that do not incorporate a one-way valve. Infant and pediatric MRBs with an expiratory valve in general yield a higher WOB than MRBs without an expiratory valve.

The 44th International Respiratory Congress Abstracts-On-DiskĀ®, November 7 - 10, 1998, Atlanta, Georgia.

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