Evaluation of Bag-Valve-Mask Ventilation in Manikin Studies: What Are the Current Limitations?
Identifieur interne : 002457 ( PubMed/Corpus ); précédent : 002456; suivant : 002458Evaluation of Bag-Valve-Mask Ventilation in Manikin Studies: What Are the Current Limitations?
Auteurs : A. Khoury ; F S Sall ; A. De Luca ; A. Pugin ; S. Pili-Floury ; L. Pazart ; G. CapellierSource :
- BioMed research international [ 2314-6141 ] ; 2016.
English descriptors
- KwdEn :
- MESH :
- adverse effects : Respiration, Artificial.
- etiology : Hyperventilation.
- instrumentation : Respiration, Artificial.
- methods : Respiration, Artificial.
- prevention & control : Hyperventilation.
- Adult, Algorithms, Female, Hand Strength, Humans, Male, Manikins, Middle Aged, Monitoring, Physiologic.
Abstract
Introduction. Manikin-based studies for evaluation of ventilation performance show high heterogeneity in the analysis and experimental methods used as we pointed out in previous studies. In this work, we aim to evaluate these potential limitations and propose a new analysis methodology to reliably assess ventilation performance. Methods. One hundred forty healthcare providers were selected to ventilate a manikin with two adult self-inflating bags in random order. Ventilation parameters were analysed using different published analysis methods compared to ours. Results. Using different methods impacts the evaluation of ventilation efficiency which ranges from 0% to 45.71%. Our new method proved relevant and showed that all professionals tend to cause hyperventilation and revealed a significant relationship between professional category, grip strength of the hand keeping the mask, and ventilation performance (p = 0.0049 and p = 0.0297, resp.). Conclusion. Using adequate analysis methods is crucial to avoid many biases. Extrapolations to humans still have to be taken with caution as many factors impact the evaluation of ventilation performance. Healthcare professionals tend to cause hyperventilation with current devices. We believe this problem could be prevented by implementing monitoring tools in order to give direct feedback to healthcare professionals regarding ventilation efficiency and ventilatory parameter values.
DOI: 10.1155/2016/4521767
PubMed: 27294119
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Khoury</name><affiliation><nlm:affiliation>Department of Emergency Medicine & Critical Care, University of Franche-Comté, Medical Centre, 25000 Besançon, France; Clinical Investigation Centre, INSERM CIC-1431, University of Franche-Comté, Medical Centre, 25000 Besançon, France.</nlm:affiliation></affiliation></author><author><name sortKey="Sall, F S" sort="Sall, F S" uniqKey="Sall F" first="F S" last="Sall">F S Sall</name><affiliation><nlm:affiliation>Department of Emergency Medicine & Critical Care, University of Franche-Comté, Medical Centre, 25000 Besançon, France; Clinical Investigation Centre, INSERM CIC-1431, University of Franche-Comté, Medical Centre, 25000 Besançon, France.</nlm:affiliation></affiliation></author><author><name sortKey="De Luca, A" sort="De Luca, A" uniqKey="De Luca A" first="A" last="De Luca">A. De Luca</name><affiliation><nlm:affiliation>Department of Emergency Medicine & Critical Care, University of Franche-Comté, Medical Centre, 25000 Besançon, France; Clinical Investigation Centre, INSERM CIC-1431, University of Franche-Comté, Medical Centre, 25000 Besançon, France.</nlm:affiliation></affiliation></author><author><name sortKey="Pugin, A" sort="Pugin, A" uniqKey="Pugin A" first="A" last="Pugin">A. Pugin</name><affiliation><nlm:affiliation>Clinical Investigation Centre, INSERM CIC-1431, University of Franche-Comté, Medical Centre, 25000 Besançon, France.</nlm:affiliation></affiliation></author><author><name sortKey="Pili Floury, S" sort="Pili Floury, S" uniqKey="Pili Floury S" first="S" last="Pili-Floury">S. 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Capellier</name><affiliation><nlm:affiliation>Department of Emergency Medicine & Critical Care, University of Franche-Comté, Medical Centre, 25000 Besançon, France; Monash University, Melbourne, VIC 3800, Australia.</nlm:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2016">2016</date><idno type="RBID">pubmed:27294119</idno><idno type="pmid">27294119</idno><idno type="doi">10.1155/2016/4521767</idno><idno type="wicri:Area/PubMed/Corpus">002457</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Corpus" wicri:corpus="PubMed">002457</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Evaluation of Bag-Valve-Mask Ventilation in Manikin Studies: What Are the Current Limitations?</title><author><name sortKey="Khoury, A" sort="Khoury, A" uniqKey="Khoury A" first="A" last="Khoury">A. Khoury</name><affiliation><nlm:affiliation>Department of Emergency Medicine & Critical Care, University of Franche-Comté, Medical Centre, 25000 Besançon, France; Clinical Investigation Centre, INSERM CIC-1431, University of Franche-Comté, Medical Centre, 25000 Besançon, France.</nlm:affiliation></affiliation></author><author><name sortKey="Sall, F S" sort="Sall, F S" uniqKey="Sall F" first="F S" last="Sall">F S Sall</name><affiliation><nlm:affiliation>Department of Emergency Medicine & Critical Care, University of Franche-Comté, Medical Centre, 25000 Besançon, France; Clinical Investigation Centre, INSERM CIC-1431, University of Franche-Comté, Medical Centre, 25000 Besançon, France.</nlm:affiliation></affiliation></author><author><name sortKey="De Luca, A" sort="De Luca, A" uniqKey="De Luca A" first="A" last="De Luca">A. De Luca</name><affiliation><nlm:affiliation>Department of Emergency Medicine & Critical Care, University of Franche-Comté, Medical Centre, 25000 Besançon, France; Clinical Investigation Centre, INSERM CIC-1431, University of Franche-Comté, Medical Centre, 25000 Besançon, France.</nlm:affiliation></affiliation></author><author><name sortKey="Pugin, A" sort="Pugin, A" uniqKey="Pugin A" first="A" last="Pugin">A. Pugin</name><affiliation><nlm:affiliation>Clinical Investigation Centre, INSERM CIC-1431, University of Franche-Comté, Medical Centre, 25000 Besançon, France.</nlm:affiliation></affiliation></author><author><name sortKey="Pili Floury, S" sort="Pili Floury, S" uniqKey="Pili Floury S" first="S" last="Pili-Floury">S. Pili-Floury</name><affiliation><nlm:affiliation>Department of Anaesthesia and Critical Care, University of Franche-Comté, Medical Centre, 25000 Besançon, France.</nlm:affiliation></affiliation></author><author><name sortKey="Pazart, L" sort="Pazart, L" uniqKey="Pazart L" first="L" last="Pazart">L. Pazart</name><affiliation><nlm:affiliation>Clinical Investigation Centre, INSERM CIC-1431, University of Franche-Comté, Medical Centre, 25000 Besançon, France.</nlm:affiliation></affiliation></author><author><name sortKey="Capellier, G" sort="Capellier, G" uniqKey="Capellier G" first="G" last="Capellier">G. Capellier</name><affiliation><nlm:affiliation>Department of Emergency Medicine & Critical Care, University of Franche-Comté, Medical Centre, 25000 Besançon, France; Monash University, Melbourne, VIC 3800, Australia.</nlm:affiliation></affiliation></author></analytic><series><title level="j">BioMed research international</title><idno type="eISSN">2314-6141</idno><imprint><date when="2016" type="published">2016</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adult</term><term>Algorithms</term><term>Female</term><term>Hand Strength</term><term>Humans</term><term>Hyperventilation (etiology)</term><term>Hyperventilation (prevention & control)</term><term>Male</term><term>Manikins</term><term>Middle Aged</term><term>Monitoring, Physiologic</term><term>Respiration, Artificial (adverse effects)</term><term>Respiration, Artificial (instrumentation)</term><term>Respiration, Artificial (methods)</term></keywords><keywords scheme="MESH" qualifier="adverse effects" xml:lang="en"><term>Respiration, Artificial</term></keywords><keywords scheme="MESH" qualifier="etiology" xml:lang="en"><term>Hyperventilation</term></keywords><keywords scheme="MESH" qualifier="instrumentation" xml:lang="en"><term>Respiration, Artificial</term></keywords><keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Respiration, Artificial</term></keywords><keywords scheme="MESH" qualifier="prevention & control" xml:lang="en"><term>Hyperventilation</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adult</term><term>Algorithms</term><term>Female</term><term>Hand Strength</term><term>Humans</term><term>Male</term><term>Manikins</term><term>Middle Aged</term><term>Monitoring, Physiologic</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Introduction. Manikin-based studies for evaluation of ventilation performance show high heterogeneity in the analysis and experimental methods used as we pointed out in previous studies. In this work, we aim to evaluate these potential limitations and propose a new analysis methodology to reliably assess ventilation performance. Methods. One hundred forty healthcare providers were selected to ventilate a manikin with two adult self-inflating bags in random order. Ventilation parameters were analysed using different published analysis methods compared to ours. Results. Using different methods impacts the evaluation of ventilation efficiency which ranges from 0% to 45.71%. Our new method proved relevant and showed that all professionals tend to cause hyperventilation and revealed a significant relationship between professional category, grip strength of the hand keeping the mask, and ventilation performance (p = 0.0049 and p = 0.0297, resp.). Conclusion. Using adequate analysis methods is crucial to avoid many biases. Extrapolations to humans still have to be taken with caution as many factors impact the evaluation of ventilation performance. Healthcare professionals tend to cause hyperventilation with current devices. We believe this problem could be prevented by implementing monitoring tools in order to give direct feedback to healthcare professionals regarding ventilation efficiency and ventilatory parameter values.</div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">27294119</PMID><DateCreated><Year>2016</Year><Month>06</Month><Day>13</Day></DateCreated><DateCompleted><Year>2017</Year><Month>02</Month><Day>21</Day></DateCompleted><DateRevised><Year>2017</Year><Month>02</Month><Day>21</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">2314-6141</ISSN><JournalIssue CitedMedium="Internet"><Volume>2016</Volume><PubDate><Year>2016</Year></PubDate></JournalIssue><Title>BioMed research international</Title><ISOAbbreviation>Biomed Res Int</ISOAbbreviation></Journal><ArticleTitle>Evaluation of Bag-Valve-Mask Ventilation in Manikin Studies: What Are the Current Limitations?</ArticleTitle><Pagination><MedlinePgn>4521767</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1155/2016/4521767</ELocationID><Abstract><AbstractText>Introduction. Manikin-based studies for evaluation of ventilation performance show high heterogeneity in the analysis and experimental methods used as we pointed out in previous studies. In this work, we aim to evaluate these potential limitations and propose a new analysis methodology to reliably assess ventilation performance. Methods. One hundred forty healthcare providers were selected to ventilate a manikin with two adult self-inflating bags in random order. Ventilation parameters were analysed using different published analysis methods compared to ours. Results. Using different methods impacts the evaluation of ventilation efficiency which ranges from 0% to 45.71%. Our new method proved relevant and showed that all professionals tend to cause hyperventilation and revealed a significant relationship between professional category, grip strength of the hand keeping the mask, and ventilation performance (p = 0.0049 and p = 0.0297, resp.). Conclusion. Using adequate analysis methods is crucial to avoid many biases. Extrapolations to humans still have to be taken with caution as many factors impact the evaluation of ventilation performance. Healthcare professionals tend to cause hyperventilation with current devices. We believe this problem could be prevented by implementing monitoring tools in order to give direct feedback to healthcare professionals regarding ventilation efficiency and ventilatory parameter values.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Khoury</LastName><ForeName>A</ForeName><Initials>A</Initials><Identifier Source="ORCID">0000-0001-7084-1508</Identifier><AffiliationInfo><Affiliation>Department of Emergency Medicine & Critical Care, University of Franche-Comté, Medical Centre, 25000 Besançon, France; Clinical Investigation Centre, INSERM CIC-1431, University of Franche-Comté, Medical Centre, 25000 Besançon, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Sall</LastName><ForeName>F S</ForeName><Initials>FS</Initials><Identifier Source="ORCID">0000-0002-8351-0406</Identifier><AffiliationInfo><Affiliation>Department of Emergency Medicine & Critical Care, University of Franche-Comté, Medical Centre, 25000 Besançon, France; Clinical Investigation Centre, INSERM CIC-1431, University of Franche-Comté, Medical Centre, 25000 Besançon, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>De Luca</LastName><ForeName>A</ForeName><Initials>A</Initials><Identifier Source="ORCID">0000-0002-0922-7311</Identifier><AffiliationInfo><Affiliation>Department of Emergency Medicine & Critical Care, University of Franche-Comté, Medical Centre, 25000 Besançon, France; Clinical Investigation Centre, INSERM CIC-1431, University of Franche-Comté, Medical Centre, 25000 Besançon, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Pugin</LastName><ForeName>A</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>Clinical Investigation Centre, INSERM CIC-1431, University of Franche-Comté, Medical Centre, 25000 Besançon, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Pili-Floury</LastName><ForeName>S</ForeName><Initials>S</Initials><AffiliationInfo><Affiliation>Department of Anaesthesia and Critical Care, University of Franche-Comté, Medical Centre, 25000 Besançon, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Pazart</LastName><ForeName>L</ForeName><Initials>L</Initials><AffiliationInfo><Affiliation>Clinical Investigation Centre, INSERM CIC-1431, University of Franche-Comté, Medical Centre, 25000 Besançon, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Capellier</LastName><ForeName>G</ForeName><Initials>G</Initials><AffiliationInfo><Affiliation>Department of Emergency Medicine & Critical Care, University of Franche-Comté, Medical Centre, 25000 Besançon, France; Monash University, Melbourne, VIC 3800, Australia.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D023362">Evaluation Studies</PublicationType><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2016</Year><Month>05</Month><Day>16</Day></ArticleDate></Article><MedlineJournalInfo><Country>United States</Country><MedlineTA>Biomed Res Int</MedlineTA><NlmUniqueID>101600173</NlmUniqueID></MedlineJournalInfo><CitationSubset>IM</CitationSubset><CommentsCorrectionsList><CommentsCorrections RefType="Cites"><RefSource>Resuscitation. 2003 May;57(2):193-9</RefSource><PMID Version="1">12745188</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>Anaesthesia. 2001 Aug;56(8):756-9</RefSource><PMID Version="1">11493238</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>Am J Emerg Med. 2012 Sep;30(7):1068-71</RefSource><PMID Version="1">21908133</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>Ann Emerg Med. 2014 Jan;63(1):14-5</RefSource><PMID 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Version="1">17179033</PMID></CommentsCorrections></CommentsCorrectionsList><MeshHeadingList><MeshHeading><DescriptorName UI="D000328" MajorTopicYN="N">Adult</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000465" MajorTopicYN="N">Algorithms</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D018737" MajorTopicYN="N">Hand Strength</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006985" MajorTopicYN="N">Hyperventilation</DescriptorName><QualifierName UI="Q000209" MajorTopicYN="N">etiology</QualifierName><QualifierName UI="Q000517" MajorTopicYN="N">prevention & control</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008348" MajorTopicYN="Y">Manikins</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008875" MajorTopicYN="N">Middle Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008991" MajorTopicYN="N">Monitoring, Physiologic</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D012121" MajorTopicYN="N">Respiration, Artificial</DescriptorName><QualifierName UI="Q000009" MajorTopicYN="N">adverse effects</QualifierName><QualifierName UI="Q000295" MajorTopicYN="Y">instrumentation</QualifierName><QualifierName UI="Q000379" MajorTopicYN="N">methods</QualifierName></MeshHeading></MeshHeadingList><OtherID Source="NLM">PMC4884794</OtherID></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2016</Year><Month>02</Month><Day>01</Day></PubMedPubDate><PubMedPubDate PubStatus="revised"><Year>2016</Year><Month>04</Month><Day>07</Day></PubMedPubDate><PubMedPubDate 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