Manual volume delivery via Frova Intubating Introducer: a bench research study

Oxygen delivery through a Frova Intubating Introducer may be life-saving, and gas flow characteristics through this device have been described. Nevertheless, the feasibility of using a self-inflating resuscitation bag to deliver air or oxygen through this device has not been assessed. We compared volumes of air delivered and peak pressures generated with normal and maximal bimanual compression of a self-inflating resuscitation bag connected to a 70 cm Frova Intubating Introducer.

In this bench research study, the proximal end of the 14-F Frova Intubating Introducer was connected to the self-inflating resuscitation bag, and the distal end was connected to a flow analyzer fitted with an adult test lung. Thirty-five anesthesia health care providers (staff/trainees) squeezed the self-inflating resuscitation bag with three normal and three maximal bimanual compressions. Endpoints of interest included the delivered volume of air and generated peak pressure.

Normal bimanual compression resulted in a smaller mean (standard deviation) volume of air and peak pressure compared with maximal bimanual compression [554 (131) vs 955 mL (121); mean difference - 400.4; 95% confidence interval [CI], - 441.8 to - 359.0; P < 0.001; and 22.0 (3.4) vs 41.8 cmH₂O (13.3); mean difference - 19.7; 95% CI, - 23.5 to - 15.9; P < 0.001, respectively].

Clinically useful, life-sustaining volumes of air can be delivered using normal and maximal bimanual compression of a self-inflating resuscitation bag connected to a 70 cm Frova Intubating Introducer.

www.clinicaltrials.gov (NCT02786355); registered 27 January, 2016.