Abstract
The effect of an on-line manometer on the variables of ventilation i.e. peak inspiratory pressure (PIP), mean airway pressure (MAP), positive end expiratory pressure (PEEP), and inspiratory to expiratory time ratio (I:E) was studied in vitro. Analysis of PIP, MAP, PEEP, and I:E was made during hand ventilation of a resuscitation mannequin at the preselected PIP of 15 and 25 cm water with and without a manometer. Use of the manometer decreased the range of variation in PIP, but the MAP was higher. This was due to an increased I:E while PEEP remained unchanged. An on-line manometer during hand ventilation prevents excessive PIP but may increase the MAP and therefore may not prevent development of a pneumothorax.
Article PDF
Similar content being viewed by others
Abbreviations
- I:E:
-
inspiratory to expiratory time ratio
- MAP:
-
mena airway pressure
- PEEP:
-
positive end expiratory pressure
- PIP:
-
peak inspiratory pressure
References
Bancalari E (1986) Inadvertent positive end-expiratory pressure during mechanical ventilation. J Pediatr 108:567–569
Banner MJ, Gallagher TJ, Bluth LI (1981) A new, microprocessor device for mean airway pressure measurement. Crit Care Med 9: 51–53
Boros SJ (1979) Variations in inspiratory: expiratory ratio and airway pressure wave form during mechanical ventilation. The significance of mean airway pressure. J Pediatr 94:114–117
Chatburn RL, Lough M, Primiano FP (1982) Modification of a ventilator pressure monitoring circuit to permit display of mean airway pressure. Respir Care 27:276–281
Ciszek TA, Modanlou HD, Owings D, Nelson P (1981) Mean airway pressure — significance during mechanical ventilation in neonates. J Pediatr 99:121–126
Duara S, Gewitz MH, Fox WW (1984) Use of mechanical ventilation for clinical management of persistent pulmonary hypertension of the newborn. Clin Perinatol 11:641–652
Field D, Milner AD, Hopkin IE (1986) Efficiency of manual resuscitators at birth. Arch Dis Child 61:300–302
Finer NN, Barrington KJ, Al-Fadley F, Peters KL (1986) Limitations of self-inflating resuscitators. Pediatrics 77:417–420
Hart SM, McNair M, Gamsu HR, Price JF (1983) Pulmonary interstitial emphysema in very low birthweight infants. Arch Dis Child 58:612–615
Heicher DA, Kasting DS, Harrod JR (1981) Prospective clinical comparison of two methods for mechanical ventilation of neonates: rapid rate and short inspiratory time versus slow rate and long inspiratory time. J Pediatr 98:957–961
Herman S, Reynolds EOR (1973) Methods for improving oxygenation in infants mechanically ventilated for severe hyaline membrane disease. Arch Dis Child 48:612–617
Morin P, Vert P (1978) Pneumothorax. Clin Perinatol 5:335–340
Morley C, South M, Milner AD (1987) Commentaries: ventilator settings for newborn infants. Arch Dis Child 62:535–538
Müller WD, Schober P (1980) Artificial ventilation in severe IRDS using inspiration plateau, prolonged expiratory time and low frequency. Helv Paediatr Acta 35:449–458
Primhak RA (1983) Factors associated with pulmonary air leak in premature infants receiving mechanical ventilation. J Pediatr 102: 764–768
Prince R, Ballantine TVN (1983) Formula for calculating mean airway pressure. J Pediatr 102:164–165
Ramsden CA, Reynolds EOR (1987) Controversy: ventilator settings for newborn infants. Arch Dis Child 62:529–534
Roberton NRC (1981) Resuscitation and initial care of the newborn. In: Roberton NRC (ed) A manual of neonatal intensive care. Edward Arnold, London, p 32
Zmora E, Merritt TA (1982) Control of peak inspiratory pressure during manual ventilation. Am J Dis Child 136:46–48
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Karsdon, J., Stijnen, T. & Berger, H.M. The effect of a manometer on the mean airway pressure during hand ventilation, an in vitro study. Eur J Pediatr 148, 574–576 (1989). https://doi.org/10.1007/BF00441562
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00441562