Defining the Efficiency of Manual Ventilation: A Comprehensive Systematic Review

Manual ventilation is an essential skill for healthcare professionals, especially in emergency and resuscitation situations where mechanical ventilation may not be immediately available. However, improper manual ventilation can lead to serious complications such as barotrauma (lung injury caused by excessive pressure), hypoventilation (leading to insufficient oxygenation), hyperventilation (which can cause respiratory alkalosis and reduced cerebral blood flow), and gastric insufflation (which increases the risk of aspiration). This review aimed to analyze the definitions and methods used to assess manual ventilation efficiency in recent studies. A systematic database search was conducted for the period between 2014 and 2023. The primary inclusion criterion was the assessment of manual ventilation quality in adults. Out of 47 identified studies, eight met the inclusion criteria in the review. Most of the reviewed studies focused on key ventilation parameters including tidal volume and ventilation rate, which are critical for ensuring adequate ventilation. However, we found considerable variability in how "effective ventilation" was defined. This review highlights the approach that considers both extrinsic and intrinsic factors as a potentially more comprehensive method for assessing manual ventilation quality. This approach may offer a more consistent and effective framework for ensuring safe and efficient manual ventilation practices.