The Science Journal of the American Association for Respiratory Care

2012 OPEN FORUM Abstracts


Kathleen Deakins, Nancy Johnson, Timothy Myers; Pediatric Respiratory Care, University Hospitals Rainbow Babies & ChildrenÂ’s, Cleveland, OH

Background During adult resuscitation, frequencies and tidal volumes typically exceed those recommended by the AHA. Excessive ventilation is associated with poor clinical outcomes after cardiopulmonary arrest. Manual ventilation devices may provide constant ventilation pressures and reduce over ventilation. The purpose of this study was to evaluate precision and accuracy of pressure delivery during manual ventilation using a resuscitation device. Methods The Ispira Emergency Pulmonary Resuscitation Device (Neoforce, Ivyland, PA) is a prototype device that incorporates a manual trigger switch on a mask that when depressed, initiates a manual breath at a target PIP. Size, 2, 3, 4 and 5 masks (#1) were individually connected to the valved end of a proprietary breathing circuit with the cushion side opposing the cushion of a matching size resuscitation mask (#2)(Medline Industries, Mundelein, IL). Masks were clamped together to simulate a mask/airway interface. The second Medline mask connector was attached to an Infant Smart Lung (BC Biomedical, St. Louis MO) with compliance at 5 ml/mbar and a resistance 5 L/sec. As adaptortor with two pressure ports connected the Medline resuscitation mask (#2) and the test lung. Pressure ltubing was connected to the Breath Tracker (Sechrist Industries, Anaheim, CA) to observe the PIP readings with each manually delivered breath. A second line was attached to the BioMed M-10 monitor (Biomed, Guilford, CT) for digital recording of PIP. A CPR Nome timer on the Inspira was set to 10 bpm to audibly cue the caregiver to trigger manual ventilation. Inspiratory time was observed at 1.0 sec on the Breath Tracker. The Inspira was preset to flow rates and PIP for each size mask and circuit. The resuscitator was cycled 50 times per circuit/mask. PIP was recorded in cmH20 from the monitor. Accuracy in achieving targeted PIP was evaluated as mean standard error (error=mean measured value / target value). Mean values for standard error were compared using a paired t -test for each mask: statistical significance set at p< 0.05.Results There was a significant difference in PIP compared to target in all but one mask. The data below summarizes measured mean PIP values with standard deviations, error in the table below: Conclusion: PIP delivered with the Ispira Resuscitator was accurate but not precise except for the Size 4 mask. While differences in PIP occurred in all but one mask, it is within a clinically acceptable range. Sponsored Research - None