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Keywords = bag-mask ventilation

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11 pages, 1459 KiB  
Article
Ultrasonography Assessment of Neck Anatomy for Prediction of Difficult Mask Ventilation in Obese Patients: A Prospective Observational Study
by Ignatius Wong Hsun-Hong, Azarinah Izaham, Syarifah Noor Nazihah Sayed Masri, Muhammad Maaya, Siti Nidzwani Mohamad Mahdi, Khazrul Nizar Abd Kader, Maryam Budiman and Yazmin Yaacob
Diagnostics 2025, 15(13), 1615; https://doi.org/10.3390/diagnostics15131615 - 25 Jun 2025
Viewed by 336
Abstract
Background: Effective mask ventilation is a very important aspect of ensuring adequate oxygenation and ventilation. However, predicting difficult mask ventilation (DMV) using bedside clinical tests remains challenging due to poor sensitivity. Our objective was to determine the correlation between the preoperative ultrasonography [...] Read more.
Background: Effective mask ventilation is a very important aspect of ensuring adequate oxygenation and ventilation. However, predicting difficult mask ventilation (DMV) using bedside clinical tests remains challenging due to poor sensitivity. Our objective was to determine the correlation between the preoperative ultrasonography of anterior neck anatomy and difficult mask ventilation in different obesity classes. Methods: A prospective, observational study enrolled 90 adult obese patients undergoing general anesthesia from December 2020 to November 2021 (30 patients for each class of obesity). Ultrasonography measurements were recorded for the distance of skin (DS) to hyoid bone (DSHB), epiglottis (DSEM), the anterior commissure of the vocal cords (DSAC), thyroid isthmus (DSTI), and trachea at jugular notch (DSTJ). The difficulty of bag mask ventilation was graded using the Han scale. The Kendall Tau correlation coefficient was used to correlate the different ultrasonography parameters to DMV. Receiver-operating characteristic (ROC) curves were used to determine the sensitivity and specificity of the measured ultrasonography distances, and the Youden index was used to calculate the optimal cut-off values. Results: Results revealed twenty patients (22.2%) were categorized as having difficult mask ventilation. There was a statistically significant increase (p = 0.011) in the number of patients with Mallampati II in class III obesity compared to class I obesity. DSHB showed a statistically significant and strong correlation with difficult mask ventilation in patients with class II (p = 0.002, r = 0.464) and class III obesity (p = 0.002, r = 0.475). A DSHB cut-off value of 1.35 cm has a sensitivity of 83.3% and specificity of 78.8% for class III obesity. Similarly, a DSTJ cut-off value of 1.13 cm has a sensitivity of 83.3% and specificity of 66.7% for class III obesity. Conclusions: Notably, DSHB was the most specific parameter and equally as sensitive as DSTJ in predicting difficult mask ventilation in morbidly obese patients. Full article
(This article belongs to the Section Medical Imaging and Theranostics)
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10 pages, 1547 KiB  
Article
A Comparative Evaluation of the Quality and Feasibility of ‘Over-the-Head’ Cardiopulmonary Resuscitation by a Single Rescuer: Pocket Mask vs. Bag-Valve Mask—A Pilot Study
by Silvia San Román-Mata, Marc Darné, Ernesto Herrera-Pedroviejo, Martín Otero-Agra, Rubén Navarro-Patón, Roberto Barcala-Furelos and Silvia Aranda-García
Healthcare 2025, 13(12), 1428; https://doi.org/10.3390/healthcare13121428 - 14 Jun 2025
Viewed by 394
Abstract
Aim: The present study evaluated the feasibility and quality of cardiopulmonary resuscitation (CPR) performed by a single rescuer, comparing the over-the-head (OTH) technique using mouth-to-pocket mask ventilation with bag-valve mask (BVM) ventilation. The study analyzed the chest compression (CC) quality, ventilation adequacy, [...] Read more.
Aim: The present study evaluated the feasibility and quality of cardiopulmonary resuscitation (CPR) performed by a single rescuer, comparing the over-the-head (OTH) technique using mouth-to-pocket mask ventilation with bag-valve mask (BVM) ventilation. The study analyzed the chest compression (CC) quality, ventilation adequacy, interruption minimization, and the rescuers’ perceived difficulty. Methods: A randomized simulation crossover study was conducted with 26 lifeguard students trained in basic life support and both ventilation techniques. All of the participants performed two solo CPR trials (2 min each) using OTH with a pocket mask or BVM on a manikin connected to a feedback system (Little Anne QCPR, Laerdal). The overall CPR quality, ventilation, and CC quality were assessed, along with the perceived difficulty (scale 0–5). A 5 min rest was provided between the trials. Results: The overall CPR quality was excellent for both techniques with a median of 98% (IQR: 97–99) for BVM-OTH and 99% (IQR: 94–99) for Pocket-OTH (p = 0.31). The ventilation quality was better when using BVM-OTH (100%, IQR: 99–100) compared to that with Pocket-OTH (99%, IQR: 77–100; p = 0.046). No differences were found in the CC quality (99%, IQR: 99–100; p = 0.24). However, Pocket-OTH had more CCs and shorter interruption times (p ≤ 0.001). The perceived difficulty was low for both techniques. Conclusions: Both techniques enable high-quality CPR when performed alone. Given that no clinically relevant differences emerged in the resuscitation quality, the OTH technique using a pocket mask offers a viable alternative, particularly in scenarios with a single rescuer and limited resources. Full article
(This article belongs to the Section Prehospital Care)
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6 pages, 1191 KiB  
Case Report
Combining a McGrath Video Laryngoscope and C-MAC Video Stylet for the Endotracheal Intubation of a Patient with a Laryngeal Carcinoma Arising from the Anterior Side of the Epiglottis: A Case Report
by Richard L. Witkam, Jörgen Bruhn, Nico Hoogerwerf, Rebecca M. Koch and Lucas T. van Eijk
Anesth. Res. 2025, 2(1), 5; https://doi.org/10.3390/anesthres2010005 - 11 Feb 2025
Viewed by 988
Abstract
Introduction: Difficult airway management is a critical challenge in anesthesia, often necessitating advanced techniques to ensure patient safety. A patient presented with a malignant lesion on the epiglottis, significantly altering the airway anatomy. Flexible rhinolaryngoscopy revealed a laryngeal carcinoma affecting the entire epiglottis, [...] Read more.
Introduction: Difficult airway management is a critical challenge in anesthesia, often necessitating advanced techniques to ensure patient safety. A patient presented with a malignant lesion on the epiglottis, significantly altering the airway anatomy. Flexible rhinolaryngoscopy revealed a laryngeal carcinoma affecting the entire epiglottis, causing thickening and displacement, which suggested the potential for difficult intubation. Methods: Given the expected feasibility of bag-mask ventilation and front-of-neck access, an asleep intubation technique was selected. The combined use of a McGrath video laryngoscope and C-MAC video stylet allowed for fast and easy atraumatic intubation on the first attempt. The anesthetic and surgical course was uneventful. Discussion: This case report highlights the successful use of a combined approach involving a video laryngoscope and video stylet for intubation in a patient with known difficulties in airway management, providing insights into the benefits of enhanced visualization and maneuverability. The rigid design and steerable tip of the C-MAC video stylet provide advantages over traditional flexible optics, offering better maneuverability and reducing the need for a second operator. Although this technique was successful in this case, its use in patients with complex airway pathologies warrants careful preoperative assessment and collaboration with an experienced airway management team. Full article
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17 pages, 6590 KiB  
Article
A Comparison of Using Cuffed and Uncuffed Face Masks for Providing Manual Bag Ventilation in Elderly Patients with Obesity
by Paweł Ratajczyk, Krzysztof Wasiak, Przemysław Kluj and Tomasz Gaszyński
Healthcare 2024, 12(22), 2214; https://doi.org/10.3390/healthcare12222214 - 6 Nov 2024
Viewed by 901
Abstract
Background: With the improvement of healthcare, the number of elderly individuals, including those with obesity, is increasing. The accumulation of various ventilation problems associated with the use of face masks in both these patient groups can pose a challenge even for an experienced [...] Read more.
Background: With the improvement of healthcare, the number of elderly individuals, including those with obesity, is increasing. The accumulation of various ventilation problems associated with the use of face masks in both these patient groups can pose a challenge even for an experienced anesthesiologist. The main aim of this study was to evaluate the ventilation of elderly patients with obesity using face masks, uncuffed or cuffed, and compare it with values obtained among patients with obesity who are not elderly. The secondary aim of the study was to demonstrate which of the two masks tested is better for elderly patients with android and gynoid obesity. Methods: This study was conducted at University Clinical Hospital No. 1 in Lodz among 108 patients with obesity, 50 elderly and 58 non-elderly. Patients’ BMIs ranged from 35.0 to 59.0. For the study, the uncuffed Intersurgical Eco Mask II and cuffed Ambu Ultra Seal face masks were used. Expiratory tidal volume and leakage obtained during the use of both types of masks were examined. The obtained data were analyzed using the Kolmogorov–Smirnov test and supplemented with Wilcoxon test values. Results: In elderly patients with obesity, especially those with gynoid obesity, the use of the Intersurgical Eco Mask II is associated with better ventilation parameters than the Ambu Ultra Seal mask. Only in the case of elderly patients with android obesity did the use of the Ambu Ultra Seal mask yield similar results to the Intersurgical Eco Mask II. Conclusions: Uncuffed face masks provide better ventilation parameters during manual bag ventilation in elderly patients with obesity. Full article
(This article belongs to the Section Critical Care)
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13 pages, 1056 KiB  
Review
Pathophysiology and Prevention of Manual-Ventilation-Induced Lung Injury (MVILI)
by Luke A. White, Steven A. Conrad and Jonathan Steven Alexander
Pathophysiology 2024, 31(4), 583-595; https://doi.org/10.3390/pathophysiology31040042 - 12 Oct 2024
Cited by 1 | Viewed by 4501
Abstract
Manual ventilation, most commonly with a bag-valve mask, is a form of short-term ventilation used during resuscitative efforts in emergent and out-of-hospital scenarios. However, compared to mechanical ventilation, manual ventilation is an operator-dependent skill that is less well controlled and is highly subject [...] Read more.
Manual ventilation, most commonly with a bag-valve mask, is a form of short-term ventilation used during resuscitative efforts in emergent and out-of-hospital scenarios. However, compared to mechanical ventilation, manual ventilation is an operator-dependent skill that is less well controlled and is highly subject to providing inappropriate ventilation to the patient. This article first reviews recent manual ventilation guidelines set forth by the American Heart Association and European Resuscitation Council for providing appropriate manual ventilation parameters (e.g., tidal volume and respiratory rate) in different patient populations in the setting of cardiopulmonary resuscitation. There is then a brief review of clinical and manikin-based studies that demonstrate healthcare providers routinely hyperventilate patients during manual ventilation, particularly in emergent scenarios. A discussion of the possible mechanisms of injury that can occur during inappropriate manual hyperventilation follows, including adverse hemodynamic alterations and lung injury such as acute barotrauma, gastric regurgitation and aspiration, and the possibility of a subacute, inflammatory-driven lung injury. Together, these injurious processes are described as manual-ventilation-induced lung injury (MVILI). This review concludes with a discussion that highlights recent progress in techniques and technologies for minimizing manual hyperventilation and MVILI, with a particular emphasis on tidal-volume feedback devices. Full article
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6 pages, 1617 KiB  
Case Report
Gastric Perforation from Bag-Valve-Mask Ventilation Resulting in Tension Pneumoperitoneum and Arterial Insufficiency
by Victor Boya Yang, Annabelle Pan, Kent Allen Stevens and James Earl Harris
Trauma Care 2024, 4(3), 200-205; https://doi.org/10.3390/traumacare4030017 - 22 Aug 2024
Cited by 1 | Viewed by 1660
Abstract
We report the case of a 44-year-old woman who suffered gastric perforation after receiving bag-valve-mask (BVM) ventilation in the setting of alcohol intoxication. She had a markedly distended abdomen and cold, dusky lower extremities upon arrival to the emergency department. Imaging revealed a [...] Read more.
We report the case of a 44-year-old woman who suffered gastric perforation after receiving bag-valve-mask (BVM) ventilation in the setting of alcohol intoxication. She had a markedly distended abdomen and cold, dusky lower extremities upon arrival to the emergency department. Imaging revealed a large volume intra-abdominal accumulation of air with compression of the aorta. Needle decompression relieved symptoms of lower extremity arterial insufficiency. However, the patient quickly decompensated and subsequent exploratory laparotomy confirmed gastric rupture. A subtotal gastrectomy was performed but the patient ultimately passed on post-operative day two due to multi-organ dysfunction. Although BVM ventilation is commonplace in both the hospital and field, there is a lack of awareness of the serious complications of abdominal air accumulation due to their rareness in the adult population. Checking for abdominal distention during resuscitation ought to be routine in all patients. Signs of arterial insufficiency accompanying abdominal distention, once confirmed by diagnostic imaging that shows extensive pneumoperitoneum, are indicators of having reached a life-threatening level of air accumulation, calling for immediate needle decompression and exploratory laparotomy. Full article
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14 pages, 4112 KiB  
Article
A Feasibility Study of a Respiratory Rate Measurement System Using Wearable MOx Sensors
by Mitsuhiro Fukuda, Jaakko Hyry, Ryosuke Omoto, Takunori Shimazaki, Takumi Kobayashi and Daisuke Anzai
Information 2024, 15(8), 492; https://doi.org/10.3390/info15080492 - 16 Aug 2024
Viewed by 1574
Abstract
Accurately obtaining a patient’s respiratory rate is crucial for promptly identifying any sudden changes in their condition during emergencies. Typically, the respiratory rate is assessed through a combination of impedance change measurements and electrocardiography (ECG). However, impedance measurements are prone to interference from [...] Read more.
Accurately obtaining a patient’s respiratory rate is crucial for promptly identifying any sudden changes in their condition during emergencies. Typically, the respiratory rate is assessed through a combination of impedance change measurements and electrocardiography (ECG). However, impedance measurements are prone to interference from body movements. Conversely, a capnometer coupled with a ventilator offers a method of measuring the respiratory rate that is unaffected by body movements. However, capnometers are mainly used to evaluate respiration when using a ventilator or an Ambu bag by measuring the CO2 concentration at the breathing circuit, and they are not used only to measure the respiratory rate. Furthermore, capnometers are not suitable as wearable devices because they require intubation or a mask that covers the nose and mouth to prevent air leaks during the measurement. In this study, we developed a reliable system for measuring the respiratory rate utilizing a small wearable MOx sensor that is unaffected by body movements and not connected to the breathing circuit. Subsequently, we conducted experimental assessments to gauge the accuracy of the rate estimation achieved by the system. In order to avoid the effects of abnormal states on the estimation accuracy, we also evaluated the classification performance for distinguishing between normal and abnormal respiration using a one-class SVM-based approach. The developed system achieved 80% for both true positive and true negative rates. Our experimental findings reveal that the respiratory rate can be precisely determined without being influenced by body movements. Full article
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11 pages, 1381 KiB  
Article
Is It Necessary to Add the Feedback Insufflation Time in Manikins? A Simulation Pilot Study
by Luis Castro-Alonso, Eloy Carracedo-Rodríguez, Martín Otero-Agra, Sheila Vázquez-Álvarez, Roberto Barcala-Furelos and María Fernández-Méndez
Reports 2024, 7(3), 64; https://doi.org/10.3390/reports7030064 - 1 Aug 2024
Viewed by 1058
Abstract
(1) Objective: This study aimed to assess the evolution of the quality of ventilations of a group of rescuers after two training sessions by taking into account inspiration times. (2) Materials and Methods: A pilot simulation study was carried out with a sample [...] Read more.
(1) Objective: This study aimed to assess the evolution of the quality of ventilations of a group of rescuers after two training sessions by taking into account inspiration times. (2) Materials and Methods: A pilot simulation study was carried out with a sample of 10 lifeguard students. Two training sessions were held three weeks apart, in which CPR skills were trained by means of feedback tools. Participants performed three tests in pairs on a ResusciAnne QCPR® manikin connected to SkillReporter QCPR software, namely one pre-training test and one test after each training session. CPR was performed in pairs for two minutes and began with five rescue breaths. (3) Results: One training session was enough to improve chest compression quality (T0: 48%; IQR 17–77/T1: 83%; IQR 59–88; p = 0.022/T2: 79%; IQR 64–92; p = 0.002). The quality of the ventilations increased progressively in each training session without reaching high-quality results (T0: 0%; IQR 0–0/T2: 15%; IQR 8–27; p = 0.011). (4) Conclusion: A two-session training program focused on inspiratory times achieved significant improvements in the quality of bag-mask ventilations performed by lifeguard students. Training focused on the insufflation time of ventilations and not only on the volume seems to be an important factor in improving the quality of ventilations. Full article
(This article belongs to the Section Critical Care/Emergency Medicine/Pulmonary)
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10 pages, 1818 KiB  
Article
Is the Over-the-Head Technique an Alternative for Infant CPR Performed by a Single Rescuer? A Randomized Simulation Study with Lifeguards
by Silvia Aranda-García, Silvia San Román-Mata, Martín Otero-Agra, Antonio Rodríguez-Núñez, María Fernández-Méndez, Rubén Navarro-Patón and Roberto Barcala-Furelos
Pediatr. Rep. 2024, 16(1), 100-109; https://doi.org/10.3390/pediatric16010010 - 29 Jan 2024
Cited by 1 | Viewed by 1870
Abstract
(1) Objective: The objective was to evaluate the quality of cardiopulmonary resuscitation (CPR, chest compressions and ventilations) when performed by a lone first responder on an infant victim via the over-the-head technique (OTH) with bag-mask ventilation in comparison with the standard lateral technique [...] Read more.
(1) Objective: The objective was to evaluate the quality of cardiopulmonary resuscitation (CPR, chest compressions and ventilations) when performed by a lone first responder on an infant victim via the over-the-head technique (OTH) with bag-mask ventilation in comparison with the standard lateral technique (LAT) position. (2) Methods: A randomized simulation crossover study in a baby manikin was conducted. A total of 28 first responders performed each of the techniques in two separate CPR tests (15:2 chest compressions:ventilations ratio), each lasting 5 min with a 15 min resting period. Quality CPR parameters were assessed using an app connected to the manikin. Those variables were related to chest compressions (CC: depth, rate, and correct CC point) and ventilation (number of effective ventilations). Additional variables included perceptions of the ease of execution of CPR. (3) Results: The median global CPR quality (integrated CC + V) was 82% with OTH and 79% with LAT (p = 0.94), whilst the CC quality was 88% with OTH and 80% with LAT (p = 0.67), and ventilation quality was 85% with OTH and 85% with LAT (p = 0.98). Correct chest release was significantly better with OTH (OTH: 92% vs. LAT: 62%, p < 0.001). There were no statistically significant differences in the remaining variables. Ease of execution perceptions favored the use of LAT over OTH. (4) Conclusions: Chest compressions and ventilations can be performed with similar quality in an infant manikin by lifeguards both with the standard recommended position (LAT) and the alternative OTH. This option could give some advantages in terms of optimal chest release between compressions. Our results should encourage the assessment of OTH in some selected cases and situations as when a lone rescuer is present and/or there are physical conditions that could impede the lateral rescue position. Full article
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9 pages, 505 KiB  
Article
Prospective Clinical Evaluation of the Singularity™ Air Laryngeal Mask in Adult Patients
by Joana Martins, Bernhard Beutel, Nadja Ettlin, Norbert Nickel, Roman Wüthrich, Roman Sandoz, Angel Borisov, JoEllen Welter and Alexander Dullenkopf
J. Clin. Med. 2023, 12(23), 7312; https://doi.org/10.3390/jcm12237312 - 25 Nov 2023
Viewed by 1150
Abstract
A laryngeal mask is one of the most widely used airway management devices. The SingularityTM Air is a second-generation laryngeal mask whose shaft angle can be adjusted after insertion. Since the device’s performance has been assessed on mannequins only, this study aimed [...] Read more.
A laryngeal mask is one of the most widely used airway management devices. The SingularityTM Air is a second-generation laryngeal mask whose shaft angle can be adjusted after insertion. Since the device’s performance has been assessed on mannequins only, this study aimed to evaluate SingularityTM Air’s effectiveness in the clinical setting. The prospective single-center cohort study included 100 adults undergoing elective surgery under general anesthesia and suitable for airway securing with a laryngeal mask. The primary endpoint was the oropharyngeal leak pressure, and the secondary endpoints were the ease of insertion and the patient’s comfort. Laryngeal mask insertion was successful in 97%, and mechanical ventilation was possible in 96% of patients. After insertion, the median (IQR) oropharyngeal leak pressure was 25 (18–25) cm H2O, which remained stable at 25 (25–25) cm H2O after 20 min. The median (IQR) time for successful manual bag ventilation was 42 (34–50) seconds. Nineteen patients complained of side effects (e.g., sore throat, difficulty swallowing), but none persisted. The SingularityTM Air performed well in a clinical setting, and its oropharyngeal leak pressure was comparable to that of other masks reported in the literature. The time for successful manual ventilation was slightly longer, and patients reported more temporary side effects. Full article
(This article belongs to the Section Anesthesiology)
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8 pages, 1503 KiB  
Case Report
Anesthetic Management for a Pregnant Patient with Bilateral Vocal Cord Granuloma Using High-Flow Nasal Cannula Oxygenation with Oxygen Reserve Index Monitoring: A Case Report
by Hyo Sung Kim, Seok Kyeong Oh, Jae Eun Lee, Hyun Ah Lee and Jae Gu Cho
Surg. Tech. Dev. 2023, 12(3), 156-163; https://doi.org/10.3390/std12030015 - 7 Sep 2023
Viewed by 2121
Abstract
Anesthetic management for pregnant patients suffering from airway pathology poses unique challenges. The presence of a bilateral vocal cord granuloma adds further complexity to anesthetic management as it can potentially cause a compromised airway and respiratory distress. This case presents a pregnant patient [...] Read more.
Anesthetic management for pregnant patients suffering from airway pathology poses unique challenges. The presence of a bilateral vocal cord granuloma adds further complexity to anesthetic management as it can potentially cause a compromised airway and respiratory distress. This case presents a pregnant patient with a bilateral vocal cord granuloma who underwent anesthesia using high-flow nasal cannula (HFNC) oxygenation and oxygen reserve index (ORi) monitoring. A 33-year-old pregnant woman, who underwent intubation six months ago, experienced hoarseness and was ultimately diagnosed with a bilateral granuloma. Due to the significant airway obstruction, neither intubation nor ventilation was feasible, thereby requiring a surgical intervention. Before the surgical removal, the patient’s oxygenation was ensured using HFNC oxygenation. After confirming the sufficient oxygenation of the patient with an ORi of 0.38, the operation commenced, and as it lasted approximately 3 min, the patient was able to tolerate the brief period without additional oxygen supply. Post-surgical excision, mask bagging, and HFNC oxygenation was resumed, driving the ORi to 0.39; then, the operation was resumed. Throughout the procedure, the SpO2 remained above 98. The combination of HFNC and ORi ensured adequate oxygenation and allowed for the early detection of hypoxemia during the procedure. This approach may be a good option for managing granulomas. Full article
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13 pages, 1038 KiB  
Article
Neurodevelopmental Outcome at 6 Months Following Neonatal Resuscitation in Rural Tanzania
by Ingrid Ask Torvik, Robert Moshiro, Hege Ersdal, Anita Yeconia, Raphael Mduma, Jeffrey Perlman and Jørgen Linde
Children 2023, 10(6), 957; https://doi.org/10.3390/children10060957 - 27 May 2023
Viewed by 2132
Abstract
Early bag-mask ventilation (BMV) administered to non-breathing neonates at birth in the presence of birth asphyxia (interruption of placental blood flow) has reduced neonatal mortality by up to 50% in low- and middle-income countries. The neurodevelopmental outcome of neonates receiving BMV remains unknown. [...] Read more.
Early bag-mask ventilation (BMV) administered to non-breathing neonates at birth in the presence of birth asphyxia (interruption of placental blood flow) has reduced neonatal mortality by up to 50% in low- and middle-income countries. The neurodevelopmental outcome of neonates receiving BMV remains unknown. Using the Malawi Developmental Assessment Tool (MDAT), infants who received BMV at birth were assessed at 6 months, evaluating gross motor, fine motor, language and social skills. A healthy cohort with no birth complications was assessed with the same tool for comparison. Mean age-adjusted MDAT z-scores were not significantly different between the groups. The number of children having developmental delay defined as a z-score ≤ −2 was significantly higher in the resuscitated cohort for the fine motor and language domain and overall MDAT z-score. The prevalence of clinical seizures post discharge was significantly higher in the resuscitated group and was associated with neurodevelopmental delay. Infants with developmental delay or seizures were more likely to have a 5 min Apgar < 7 and a longer duration of BMV. Most children receiving BMV at birth are developing normally at 6 months. Still, there are some children with impaired development among resuscitated children, representing a subgroup of children who may have suffered more severe asphyxia. Full article
(This article belongs to the Section Pediatric Neonatology)
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13 pages, 1267 KiB  
Article
Delayed and Interrupted Ventilation with Excess Suctioning after Helping Babies Breathe with Congolese Birth Attendants
by Jackie K. Patterson, Daniel Ishoso, Joar Eilevstjønn, Melissa Bauserman, Ingunn Haug, Pooja Iyer, Beena D. Kamath-Rayne, Adrien Lokangaka, Casey Lowman, Eric Mafuta, Helge Myklebust, Tracy Nolen, Janna Patterson, Antoinette Tshefu, Carl Bose and Sara Berkelhamer
Children 2023, 10(4), 652; https://doi.org/10.3390/children10040652 - 30 Mar 2023
Cited by 9 | Viewed by 2357
Abstract
There is a substantial gap in our understanding of resuscitation practices following Helping Babies Breathe (HBB) training. We sought to address this gap through an analysis of observed resuscitations following HBB 2nd edition training in the Democratic Republic of the Congo. This is [...] Read more.
There is a substantial gap in our understanding of resuscitation practices following Helping Babies Breathe (HBB) training. We sought to address this gap through an analysis of observed resuscitations following HBB 2nd edition training in the Democratic Republic of the Congo. This is a secondary analysis of a clinical trial evaluating the effect of resuscitation training and electronic heart rate monitoring on stillbirths. We included in-born, liveborn neonates ≥28 weeks gestation whose resuscitation care was directly observed and documented. For the 2592 births observed, providers dried/stimulated before suctioning in 97% of cases and suctioned before ventilating in 100%. Only 19.7% of newborns not breathing well by 60 s (s) after birth ever received ventilation. Providers initiated ventilation at a median 347 s (>five minutes) after birth; no cases were initiated within the Golden Minute. During 81 resuscitations involving ventilation, stimulation and suction both delayed and interrupted ventilation with a median 132 s spent drying/stimulating and 98 s suctioning. This study demonstrates that HBB-trained providers followed the correct order of resuscitation steps. Providers frequently failed to initiate ventilation. When ventilation was initiated, it was delayed and interrupted by stimulation and suctioning. Innovative strategies targeting early and continuous ventilation are needed to maximize the impact of HBB. Full article
(This article belongs to the Special Issue Newborn Resuscitation: Advances in Training and Practice: 2nd Edition)
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10 pages, 2977 KiB  
Article
Pediatric Ventilation Skills by Non-Healthcare Students: Effectiveness, Self-Perception, and Preference
by Santiago Martínez-Isasi, Cristina Jorge-Soto, Cecilia Castro-Fernández, Clara Baltar-Lorenzo, María Sobrido-Prieto, Jose Manteiga-Urbón and Roberto Barcala-Furelos
Int. J. Environ. Res. Public Health 2023, 20(4), 3026; https://doi.org/10.3390/ijerph20043026 - 9 Feb 2023
Viewed by 1786
Abstract
Since a great number of infant cardiopulmonary arrests occur outside of the hospital, it is crucial to train laypersons in cardiopulmonary resuscitation techniques, especially those professionals that will work with infants and children. The main objective of this study was to evaluate the [...] Read more.
Since a great number of infant cardiopulmonary arrests occur outside of the hospital, it is crucial to train laypersons in cardiopulmonary resuscitation techniques, especially those professionals that will work with infants and children. The main objective of this study was to evaluate the efectiveness of ventilations performed by professional training students. The secondary objective was to analyze the preference between different ventilation and chest-compression methods. The sample consisted of 32 professional training students, 15 preschool students, and 17 physical education students. The activity was conducted separately for each group, and we provided a 10 min theoretical training about infant basic life support followed by a 45 min practical training using a Laerdal Little Anne QCPR CPR manikin. A practical test in pairs was organized to record the ventilation as performed by the participants, establishing the difference between the efficacious and the non-efficacious ones. Furthermore, we handed out a survey before and after training to evaluate their knowledge. More than 90% of the students completely agreed with the importance of learning cardiopulmonary resuscitation techniques for their professional future. More than half of the sample considered that they perform the rescue breathings with the mouth-to-mouth method better. We observed that through mouth-to-mouth-nose ventilations, the number of effective ventilations was significantly higher than the effective ventilations provided by a self-inflating bag and mask (EffectiveMtoMN 6.42 ± 4.27 vs. EffectiveMask 4.75 ± 3.63 (p = 0.007)), which was the preferred method. In terms of the compression method, hands encircling the chest was preferred by more than 85% of students. Mouth-to-mouth nose ventilation is more efficient than bag-face-mask ventilation in CPR as performed by professional training and physical activity students. This fact must be considered to provide higher-quality training sessions to professional training students. Full article
(This article belongs to the Special Issue Advancing Research on Emergency Care)
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12 pages, 1388 KiB  
Study Protocol
Effect of Intermediate Airway Management on Ventilation Parameters in Simulated Pediatric Out-of-Hospital Cardiac Arrest: Protocol for a Multicenter, Randomized, Crossover Trial
by Loric Stuby, Elisa Mühlemann, Laurent Jampen, David Thurre, Johan N. Siebert and Laurent Suppan
Children 2023, 10(1), 148; https://doi.org/10.3390/children10010148 - 12 Jan 2023
Cited by 1 | Viewed by 2920
Abstract
Most pediatric out-of-hospital cardiac arrests (OHCAs) are caused by hypoxia, which is generally consecutive to respiratory failure. To restore oxygenation, prehospital providers usually first use basic airway management techniques, i.e., bag-valve-mask (BVM) devices. These devices present several drawbacks, most of which could be [...] Read more.
Most pediatric out-of-hospital cardiac arrests (OHCAs) are caused by hypoxia, which is generally consecutive to respiratory failure. To restore oxygenation, prehospital providers usually first use basic airway management techniques, i.e., bag-valve-mask (BVM) devices. These devices present several drawbacks, most of which could be avoided using supraglottic airway devices. These intermediate airway management (IAM) devices also present significant advantages over tracheal intubation: they are associated with higher success and lower complication rates in the prehospital setting. There are, however, few data regarding the effect of early IAM in pediatric OHCA. This paper details the protocol of a trial designed to evaluate the impact of this airway management strategy on ventilation parameters through a simulated, multicenter, randomized, crossover trial. The hypothesis underlying this study protocol is that early IAM without prior BVM ventilations could improve the ventilation parameters in comparison with the standard approach, which consists in BVM ventilations only. Full article
(This article belongs to the Special Issue Pediatric Airway Management: Advances and Future Challenges)
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