Effect of Proximal Oxygen Adding to a Bag Valve Mask with a Mechanical Filter in Healthy Volunteers: A Randomized Crossover Trial
17
Issued Date
2023-01-01
Resource Type
ISSN
01252208
Scopus ID
2-s2.0-85146459832
Journal Title
Journal of the Medical Association of Thailand
Volume
106
Issue
1
Start Page
49
End Page
55
Rights Holder(s)
SCOPUS
Bibliographic Citation
Journal of the Medical Association of Thailand Vol.106 No.1 (2023) , 49-55
Suggested Citation
Watcharotayangul J., Thummata G., Srisitpisarn K., Virankabutra T., Thamjamrassri T. Effect of Proximal Oxygen Adding to a Bag Valve Mask with a Mechanical Filter in Healthy Volunteers: A Randomized Crossover Trial. Journal of the Medical Association of Thailand Vol.106 No.1 (2023) , 49-55. 55. doi:10.35755/jmedassocthai.2023.01.13739 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/82601
Title
Effect of Proximal Oxygen Adding to a Bag Valve Mask with a Mechanical Filter in Healthy Volunteers: A Randomized Crossover Trial
Author's Affiliation
Other Contributor(s)
Abstract
Background: Preoxygenation using a bag valve mask (BVM) with a filter is recommended to reduce the risk of viral transmission. Preoxygenation in hypoxaemic patients may require a positive end-expiratory pressure (PEEP) valve. Applying a filter to a BVM with or without a PEEP valve can increase resistance and work of breathing. Objective: To evaluate the efficacy of proximal oxygen added to BVM with mechanical filter in healthy volunteers. Materials and Methods: The present study was a crossover trial that randomized 48 volunteers to receive four preoxygenation techniques: BVM with a filter as group F, BVM with a filter and proximal oxygen as group FO, BVM with a filter and PEEP valve as group FP, and BVM with a filter, PEEP valve, and proximal oxygen as group FPO. Fraction of expired oxygen (FEO2) and continuous positive airway pressure (CPAP) were measured. Comfort was assessed using a numerical rating scale (NRS). The primary outcome was FEO2 at five minutes. Results: Data from 46 volunteers were analyzed. Adding oxygen proximal to the filter in the FO group increased FEO2 at five minutes by 7.07% (95% CI 4.87 to 9.26) and decreased the time to reach FEO2 90% by 301.74 seconds (95% CI 282.82 to 320.66) compared with the times in group F. Similarly, supplemental proximal oxygen including a PEEP valve increased FEO2 at five minutes by 6.07% (95% CI 3.87 to 8.26) and decreased the time to reach FEO2 90% by 242.13 seconds (95% CI 223.21 to 261.05). CPAP was 2.27, 3.61, 11.65, and 13.14 mmHg in group F, FO, FP, and FPO, respectively. The NRS score was 6.51 and 6.07 in groups F and FO, and 3.15 and 3.70 in groups FP and FPO, respectively. Conclusion: Adding proximal oxygen to a BVM with a filter improved the efficacy of preoxygenation.