RT Journal Article
SR Electronic
T1 Ventilation Efficacy of Video-Laryngoscope Equipped With a Ventilation Feature
JF Respiratory Care
FD American Association for Respiratory Care
SP respcare.03169
DO 10.4187/respcare.03169
A1 Jun Oto
A1 Christopher T Chenelle
A1 Zhenbo Su
A1 Mary Q Sun
A1 Yandong Jiang
A1 Robert M Kacmarek
YR 2014
UL http://rc.rcjournal.com/content/early/2014/08/26/respcare.03169.abstract
AB INTRODUCTION: Achieving effective ventilation is challenging for anesthesia care providers and emergency medical personnel, as difficult mask ventilation and difficult intubation frequently occur. The aim of this study was to determine whether video-laryngoscopes equipped with a ventilation feature can produce effective ventilation. METHODS: An intubation mannequin with its trachea connected to a model lung with compliance 50 (normal compliance: C50) and 20 mL/cm H2O (low compliance: C20) was used. Ventilation was established via a ventilation catheter (inner diameter 3.5 mm, 50 cm length) extending to the tip of the video-laryngoscope blade. Three different views of the vocal cords (grade 1, vocal cords fully visualized; grade 2, partial vocal cord visualization; grade 3, only epiglottis visualized) were tested. Ventilation was provided by jet ventilator (Jet). The Jet was operated at 10, 15, and 20 psi (Jet10, Jet15, and Jet20). Effective tidal volume (VT) was defined as a VT greater than anatomical dead space (150 mL). RESULTS: In C50, Jet15 and Jet20 generated effective VT in all vocal cord views (for Jet15: grade 1, 663 ± 33 mL; grade 2, 363 ± 25 mL; and grade 3, 198 ± 9 mL; for Jet20: grade 1, 1,005 ± 114 mL; grade 2, 484 ± 38 mL; grade 3, 268 ± 8 mL, respectively). In C20, Jet15 and Jet20 generated effective VT in grades 1 and 2 (Jet15: grade 1, 288 ± 8 mL; grade 2, 160 ± 20 mL; grade 3, 81 ± 7 mL; Jet20: grade 1, 421 ± 20 mL; grade 2, 222 ± 16 mL; grade 3, 111 ± 8 mL, respectively). Jet10 achieved effective VT in grade 1 and 2 (grade 1, 354 ± 6 mL; grade 2, 223 ± 37 mL, respectively) in C50 and grade 1 (163 ± 12 mL) in C20. CONCLUSIONS: Video-laryngoscopes equipped with a ventilation feature provided effective VT in simulated clinical scenarios. Further clinical study is required to validate these findings.