This study hypothesizes that a novel reversal V-E ventilation technique will retain its high efficiency as that of standard V-E technique and will be easier to use.
Despite advances in intubation technology, difficult airways persist. Because it is failure to oxygenate, not failure to intubate, that ultimately leads to brain injury and cardiovascular collapse, effective mask ventilation is at least as important as successful intubation. Therefore optimizing mask ventilation is crucial for clinicians. When difficult mask ventilation encounters, clinicians often switch to two hand technique to hold the mask including either "C-E" clamp or "V-E" clamp. Both volume mode ventilation and pressure mode ventilation are superior with the V-E technique as compared to the C-E technique. The study will test the hypothesis that a novel reversal V-E mask ventilation technique will retain its high efficiency as that of standard V-E technique but be easier to use than standard V-E technique.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
OTHER
Masking
NONE
Enrollment
92
For the two-handed standard V-E technique, the facemask is first placed over the bridge of the nose and mouth and then held in place by performing at two-handed jaw thrust maneuver with the index and second finger of each hand and maintaining mask contact with the patient's face by using both thumbs with mouth open. A head-tilt is performed by applying a caudal force on the mandible and mask.
While using reversal V-E technique, the anesthesia provider stands 180 degrees opposite from the head of the bed. Thenar eminence and thumbs secure the mask around the nose while the remaining fingers pull the mandible anteriorly while keeping the mouth open.
Vanderbilt University Medical Center
Nashville, Tennessee, United States
Visual score of friendliness of mask holding technique using 11 point scale
Visual score of friendliness of mask holding technique using 11 point scale when 0 is easy and 10 is difficult.
Time frame: Conclusion of masked ventilation (approximately 5 minutes)
AUC of exhaled tidal volume (Vt) trace
Comparison of AUC of exhaled tidal volume trace
Time frame: Period of masked ventilation (approximately 5 minutes)
Vt/AUC
Vt/AUC of exhaled Vt
Time frame: Period of masked ventilation (approximately 5 minutes)
Peak inspiratory airway pressure
Peak inspiratory airway pressure
Time frame: Period of masked ventilation (approximately 5 minutes)
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