Evaluation of manual resuscitators used in ICUs in Brazil

• Published in: Jornal brasileiro de pneumologia 2013-09, Vol.39 (5), p.595-603
• Main Authors: Ortiz, Tatiana de Arruda, Forti, Jr, Germano, Volpe, Márcia Souza, Beraldo, Marcelo do Amaral, Amato, Marcelo Britto Passos, Carvalho, Carlos Roberto Ribeiro, Tucci, Mauro Roberto
• Format: Article
• Language: eng ; por
• Subjects: Brazil; Comparative Effectiveness Research - methods; Computer Simulation - standards; Desenho de equipamento; Female; Humans; Intensive Care Units; Male; Observer Variation; Original; Respiracao artificial; Respiracao com pressao positiva; Respiratory Mechanics - physiology; RESPIRATORY SYSTEM; Ressuscitacao; Resuscitation - instrumentation; Seguranca de equipamentos; Teste de materiais; Tidal Volume; Ventilators, Mechanical - standards; Ventilators, Mechanical - statistics & numerical data
• ISSN: 1806-3713; 1806-3756; 1806-3756; 1806-3713
• DOI: 10.1590/S1806-37132013000500010

To evaluate the performance of manual resuscitators (MRs) used in Brazil in accordance with international standards. Using a respiratory system simulator, four volunteer physiotherapists employed eight MRs (five produced in Brazil and three produced abroad), which were tested for inspiratory and expiratory resistance of the patient valve; functioning of the pressure-limiting valve; and tidal volume (VT) generated when the one-handed and two-handed techniques were used. The tests were performed and analyzed in accordance with the American Society for Testing and Materials (ASTM) F920-93 criteria. Expiratory resistance was greater than 6 cmH2O . L-1 . s-1 in only one MR. The pressure-limiting valve, a feature of five of the MRs, opened at low pressures (< 17 cmH2O), and the maximal pressure was 32.0-55.9 cmH2O. Mean VT varied greatly among the MRs tested. The mean VT values generated with the one-handed technique were lower than the 600 mL recommended by the ASTM. In the situations studied, mean VT was generally lower from the Brazilian-made MRs that had a pressure-limiting valve. The resistances imposed by the patient valve met the ASTM criteria in all but one of the MRs tested. The pressure-limiting valves of the Brazilian-made MRs usually opened at low pressures, providing lower VT values in the situations studied, especially when the one-handed technique was used, suggesting that both hands should be used and that the pressure-limiting valve should be closed whenever possible.