The effect of a manometer on the mean airway pressure during hand ventilation, an in vitro study

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.