Comparison of Three Methods in Improving Bag Mask Ventilation
Identifieur interne : 001554 ( Pmc/Checkpoint ); précédent : 001553; suivant : 001555Comparison of Three Methods in Improving Bag Mask Ventilation
Auteurs : Samad Ej Golzari [Iran] ; Hassan Soleimanpour [Iran] ; Hamidreza Mehryar [Iran] ; Shaker Salarilak [Iran] ; Ata Mahmoodpoor [Iran] ; Jafar Rahimi Panahi [Iran] ; Mohammadreza Afhami [Iran] ; Majid Sabahi [Iran] ; Zahra Hassani [Iran]Source :
- International Journal of Preventive Medicine [ 2008-7802 ] ; 2014.
Abstract
Increasedlife expectancy in populations has brought along specific new scenarios in the fields of medicine for the elderly; prevalence of physical complications such as edentulism and patients with dentures is growing. Management of anesthesia and ventilation in this group of patients has turned into a great challenge. Some researchers suggest dentures to be left in place during bag-mask ventilation; yet, no unanimous agreement exists in this regard.
In a single blind randomized clinical trial, we studied 300 patients with ASA class I, II (American Society of Anesthesiologists), Mallampati class (I, II) and aged over 55 years in three groups. After induction of anesthesia, in group G dentures were removed and in each buccal space an eight-layer 10 × 10 cm gauze and an oral airway were placed. In group D, the dentures and an oral airway were left in place. In group C (control), after removing dentures just an appropriate oral airway was placed. Then, each three group underwent bag-mask ventilation. Success of bag-mask ventilation (BMV) was considered as increase in end-tidal carbon dioxide to more than 20 mmHg and back to baseline with fresh gas flow of 3 L/min and adjustable pressure limiting valve pressure of 20 cm H2O. Success rates were evaluated between groups.
Effective BMV was possible in 91 (91%), 64 (64%) and 41 (41%) patients in groups G, D and C respectively. The differences were statistically significant. Successful BMV rate was significantly higher in female patients in group G compared to group C; 43/44 versus 25/46 individuals,
Leaving dentures in place in edentulous patients after inducing anesthesia improves bag-mask ventilation. However, placing folded compressed gauze in buccal space leads to more significant improvement in BMV compared to leaving dentures in place.
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PubMed: 24829737
PubMed Central: 4018598
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<front><div type="abstract" xml:lang="en"><sec id="st1"><title>Introduction:</title>
<p>Increasedlife expectancy in populations has brought along specific new scenarios in the fields of medicine for the elderly; prevalence of physical complications such as edentulism and patients with dentures is growing. Management of anesthesia and ventilation in this group of patients has turned into a great challenge. Some researchers suggest dentures to be left in place during bag-mask ventilation; yet, no unanimous agreement exists in this regard.</p>
</sec>
<sec id="st2"><title>Methods:</title>
<p>In a single blind randomized clinical trial, we studied 300 patients with ASA class I, II (American Society of Anesthesiologists), Mallampati class (I, II) and aged over 55 years in three groups. After induction of anesthesia, in group G dentures were removed and in each buccal space an eight-layer 10 × 10 cm gauze and an oral airway were placed. In group D, the dentures and an oral airway were left in place. In group C (control), after removing dentures just an appropriate oral airway was placed. Then, each three group underwent bag-mask ventilation. Success of bag-mask ventilation (BMV) was considered as increase in end-tidal carbon dioxide to more than 20 mmHg and back to baseline with fresh gas flow of 3 L/min and adjustable pressure limiting valve pressure of 20 cm H<sub>2</sub>
O. Success rates were evaluated between groups.</p>
</sec>
<sec id="st3"><title>Results:</title>
<p>Effective BMV was possible in 91 (91%), 64 (64%) and 41 (41%) patients in groups G, D and C respectively. The differences were statistically significant. Successful BMV rate was significantly higher in female patients in group G compared to group C; 43/44 versus 25/46 individuals, <italic>P</italic>
= 0.0001, odds ratio = 0.03, 95% confidence interval (0.00, 0.22).</p>
</sec>
<sec id="st4"><title>Conclusions:</title>
<p>Leaving dentures in place in edentulous patients after inducing anesthesia improves bag-mask ventilation. However, placing folded compressed gauze in buccal space leads to more significant improvement in BMV compared to leaving dentures in place.</p>
</sec>
</div>
</front>
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<pmc article-type="research-article"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">Int J Prev Med</journal-id>
<journal-id journal-id-type="iso-abbrev">Int J Prev Med</journal-id>
<journal-id journal-id-type="publisher-id">IJPVM</journal-id>
<journal-title-group><journal-title>International Journal of Preventive Medicine</journal-title>
</journal-title-group>
<issn pub-type="ppub">2008-7802</issn>
<issn pub-type="epub">2008-8213</issn>
<publisher><publisher-name>Medknow Publications & Media Pvt Ltd</publisher-name>
<publisher-loc>India</publisher-loc>
</publisher>
</journal-meta>
<article-meta><article-id pub-id-type="pmid">24829737</article-id>
<article-id pub-id-type="pmc">4018598</article-id>
<article-id pub-id-type="publisher-id">IJPVM-5-489</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Original Article</subject>
</subj-group>
</article-categories>
<title-group><article-title>Comparison of Three Methods in Improving Bag Mask Ventilation</article-title>
</title-group>
<contrib-group><contrib contrib-type="author"><name><surname>Golzari</surname>
<given-names>Samad EJ</given-names>
</name>
<xref ref-type="aff" rid="aff1"></xref>
</contrib>
<contrib contrib-type="author"><name><surname>Soleimanpour</surname>
<given-names>Hassan</given-names>
</name>
<xref ref-type="aff" rid="aff2">1</xref>
<xref ref-type="corresp" rid="cor1"></xref>
</contrib>
<contrib contrib-type="author"><name><surname>Mehryar</surname>
<given-names>Hamidreza</given-names>
</name>
<xref ref-type="aff" rid="aff3">2</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Salarilak</surname>
<given-names>Shaker</given-names>
</name>
<xref ref-type="aff" rid="aff4">3</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Mahmoodpoor</surname>
<given-names>Ata</given-names>
</name>
<xref ref-type="aff" rid="aff5">4</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Panahi</surname>
<given-names>Jafar Rahimi</given-names>
</name>
<xref ref-type="aff" rid="aff5">4</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Afhami</surname>
<given-names>Mohammadreza</given-names>
</name>
<xref ref-type="aff" rid="aff5">4</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Sabahi</surname>
<given-names>Majid</given-names>
</name>
<xref ref-type="aff" rid="aff6">5</xref>
<xref ref-type="aff" rid="aff7">6</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Hassani</surname>
<given-names>Zahra</given-names>
</name>
<xref ref-type="aff" rid="aff8">7</xref>
</contrib>
</contrib-group>
<aff id="aff1">Liver and Gastrointestinal Disease Research Center, Tabriz University of Medical Sciences, Tabriz, Iran</aff>
<aff id="aff2"><label>1</label>
Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran</aff>
<aff id="aff3"><label>2</label>
Department of Emergency Medicine, Urmia University of Medical Sciences, Urmia, Iran</aff>
<aff id="aff4"><label>3</label>
Department of Public Health, Faculty of Medicine, Tabriz Branch, Islamic Azad University, Tabriz, Iran</aff>
<aff id="aff5"><label>4</label>
Department of Anesthesiology, Tabriz University of Medical Sciences, Tabriz, I.R, Iran</aff>
<aff id="aff6"><label>5</label>
Heart and Stroke Foundation of Canada, Tabriz University of Medical Sciences, Tabriz, Iran</aff>
<aff id="aff7"><label>6</label>
Sunny Brook Hospital, University of Toronto, Tabriz, Iran</aff>
<aff id="aff8"><label>7</label>
Students’ Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran</aff>
<author-notes><corresp id="cor1"><bold>Correspondence to:</bold>
Dr. Hassan Soleimanpour, Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran. E-mail: <email xlink:href="soleimanpourh@tbzmed.ac.ir">soleimanpourh@tbzmed.ac.ir</email>
</corresp>
</author-notes>
<pub-date pub-type="ppub"><month>4</month>
<year>2014</year>
</pub-date>
<volume>5</volume>
<issue>4</issue>
<fpage>489</fpage>
<lpage>493</lpage>
<history><date date-type="received"><day>08</day>
<month>5</month>
<year>2013</year>
</date>
<date date-type="accepted"><day>04</day>
<month>11</month>
<year>2013</year>
</date>
</history>
<permissions><copyright-statement>Copyright: © International Journal of Preventive Medicine</copyright-statement>
<copyright-year>2014</copyright-year>
<license license-type="open-access" xlink:href="http://creativecommons.org/licenses/by-nc-sa/3.0"><license-p>This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.</license-p>
</license>
</permissions>
<abstract><sec id="st1"><title>Introduction:</title>
<p>Increasedlife expectancy in populations has brought along specific new scenarios in the fields of medicine for the elderly; prevalence of physical complications such as edentulism and patients with dentures is growing. Management of anesthesia and ventilation in this group of patients has turned into a great challenge. Some researchers suggest dentures to be left in place during bag-mask ventilation; yet, no unanimous agreement exists in this regard.</p>
</sec>
<sec id="st2"><title>Methods:</title>
<p>In a single blind randomized clinical trial, we studied 300 patients with ASA class I, II (American Society of Anesthesiologists), Mallampati class (I, II) and aged over 55 years in three groups. After induction of anesthesia, in group G dentures were removed and in each buccal space an eight-layer 10 × 10 cm gauze and an oral airway were placed. In group D, the dentures and an oral airway were left in place. In group C (control), after removing dentures just an appropriate oral airway was placed. Then, each three group underwent bag-mask ventilation. Success of bag-mask ventilation (BMV) was considered as increase in end-tidal carbon dioxide to more than 20 mmHg and back to baseline with fresh gas flow of 3 L/min and adjustable pressure limiting valve pressure of 20 cm H<sub>2</sub>
O. Success rates were evaluated between groups.</p>
</sec>
<sec id="st3"><title>Results:</title>
<p>Effective BMV was possible in 91 (91%), 64 (64%) and 41 (41%) patients in groups G, D and C respectively. The differences were statistically significant. Successful BMV rate was significantly higher in female patients in group G compared to group C; 43/44 versus 25/46 individuals, <italic>P</italic>
= 0.0001, odds ratio = 0.03, 95% confidence interval (0.00, 0.22).</p>
</sec>
<sec id="st4"><title>Conclusions:</title>
<p>Leaving dentures in place in edentulous patients after inducing anesthesia improves bag-mask ventilation. However, placing folded compressed gauze in buccal space leads to more significant improvement in BMV compared to leaving dentures in place.</p>
</sec>
</abstract>
<kwd-group><kwd>Bag-mask ventilation</kwd>
<kwd>dentures</kwd>
<kwd>edentulous patients</kwd>
<kwd>end-tidal carbon dioxide</kwd>
<kwd>folded gauze</kwd>
</kwd-group>
</article-meta>
</front>
</pmc>
<affiliations><list><country><li>Iran</li>
</country>
<region><li>Ontario</li>
</region>
<settlement><li>Toronto</li>
</settlement>
<orgName><li>Université de Toronto</li>
</orgName>
</list>
<tree><country name="Iran"><noRegion><name sortKey="Golzari, Samad Ej" sort="Golzari, Samad Ej" uniqKey="Golzari S" first="Samad Ej" last="Golzari">Samad Ej Golzari</name>
</noRegion>
<name sortKey="Afhami, Mohammadreza" sort="Afhami, Mohammadreza" uniqKey="Afhami M" first="Mohammadreza" last="Afhami">Mohammadreza Afhami</name>
<name sortKey="Hassani, Zahra" sort="Hassani, Zahra" uniqKey="Hassani Z" first="Zahra" last="Hassani">Zahra Hassani</name>
<name sortKey="Mahmoodpoor, Ata" sort="Mahmoodpoor, Ata" uniqKey="Mahmoodpoor A" first="Ata" last="Mahmoodpoor">Ata Mahmoodpoor</name>
<name sortKey="Mehryar, Hamidreza" sort="Mehryar, Hamidreza" uniqKey="Mehryar H" first="Hamidreza" last="Mehryar">Hamidreza Mehryar</name>
<name sortKey="Panahi, Jafar Rahimi" sort="Panahi, Jafar Rahimi" uniqKey="Panahi J" first="Jafar Rahimi" last="Panahi">Jafar Rahimi Panahi</name>
<name sortKey="Sabahi, Majid" sort="Sabahi, Majid" uniqKey="Sabahi M" first="Majid" last="Sabahi">Majid Sabahi</name>
<name sortKey="Sabahi, Majid" sort="Sabahi, Majid" uniqKey="Sabahi M" first="Majid" last="Sabahi">Majid Sabahi</name>
<name sortKey="Salarilak, Shaker" sort="Salarilak, Shaker" uniqKey="Salarilak S" first="Shaker" last="Salarilak">Shaker Salarilak</name>
<name sortKey="Soleimanpour, Hassan" sort="Soleimanpour, Hassan" uniqKey="Soleimanpour H" first="Hassan" last="Soleimanpour">Hassan Soleimanpour</name>
</country>
</tree>
</affiliations>
</record>
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