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BioMed Research International
Volume 2016, Article ID 4521767, 8 pages
Research Article

Evaluation of Bag-Valve-Mask Ventilation in Manikin Studies: What Are the Current Limitations?

1Department of Emergency Medicine & Critical Care, University of Franche-Comté, Medical Centre, 25000 Besançon, France
2Clinical Investigation Centre, INSERM CIC-1431, University of Franche-Comté, Medical Centre, 25000 Besançon, France
3Department of Anaesthesia and Critical Care, University of Franche-Comté, Medical Centre, 25000 Besançon, France
4Monash University, Melbourne, VIC 3800, Australia

Received 1 February 2016; Revised 7 April 2016; Accepted 19 April 2016

Academic Editor: Han-Ping Wu

Copyright © 2016 A. Khoury et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Introduction. Manikin-based studies for evaluation of ventilation performance show high heterogeneity in the analysis and experimental methods used as we pointed out in previous studies. In this work, we aim to evaluate these potential limitations and propose a new analysis methodology to reliably assess ventilation performance. Methods. One hundred forty healthcare providers were selected to ventilate a manikin with two adult self-inflating bags in random order. Ventilation parameters were analysed using different published analysis methods compared to ours. Results. Using different methods impacts the evaluation of ventilation efficiency which ranges from 0% to 45.71%. Our new method proved relevant and showed that all professionals tend to cause hyperventilation and revealed a significant relationship between professional category, grip strength of the hand keeping the mask, and ventilation performance ( and , resp.). Conclusion. Using adequate analysis methods is crucial to avoid many biases. Extrapolations to humans still have to be taken with caution as many factors impact the evaluation of ventilation performance. Healthcare professionals tend to cause hyperventilation with current devices. We believe this problem could be prevented by implementing monitoring tools in order to give direct feedback to healthcare professionals regarding ventilation efficiency and ventilatory parameter values.