Srovnání ventilačních parametrů samorozpínacích vaků

Introduction

Excessive ventilation of sick and injured patients is associated with increased morbidity and mortality.1–5 The current standard of practice is the use of a traditional bag-valve-mask (BVM) to provide ventilation to critically ill and/or injured persons. Current BVM devices do not have a method to control ventilation rate and this may contribute to excessive ventilation rates, which have been implicated in iatrogenically induced morbidity and mortality. Excessive ventilation with BVM devices can occur among well-trained healthcare professionals and is not limited to unusual circumstances or the undertrained. The minute ventilation provided to patients is the product of the ventilation rate and tidal volume (TV) delivered, both of which are controlled by the operator of the device. Because excessive ventilation depends on the individual healthcare provider, changes in the equipment that address rate, TV, or both could decrease or eliminate this error. Therefore, it has been recommended that a means to remove the human error component in the use of the BVM device be further developed. Combat Medical Systems® (CMS; http://www.combatmedical systems.com) is developing a new BVM device that limits the rate of ventilation by controlling the amount of time for the bag to inflate. This device uses a spring to inflate over 5–6 seconds and is designed to prevent excessive ventilation. It is also designed to be completely compressed, with the intent of reducing variability in TVs. This device has the potential to address many of the current shortcomings of the traditional BVM.