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Randomized Controlled Trial
, 27 (1), 93

Ventilation Feedback Device for Manual Ventilation in Simulated Respiratory Arrest: A Crossover Manikin Study

Randomized Controlled Trial

Ventilation Feedback Device for Manual Ventilation in Simulated Respiratory Arrest: A Crossover Manikin Study

Abdo Khoury et al. Scand J Trauma Resusc Emerg Med.


Background: Studies have shown that providing adequate ventilation during CPR is essential. While hypoventilation is often feared by most caregivers on the scene, the most critical problem remains hyperventilation. We developed a Ventilation Feedback Device (VFD) for manual ventilation which monitors ventilatory parameters and provides direct feedback about ventilation quality to the rescuer. This study aims to compare the quality of conventional manual ventilation to ventilation with VFD on a simulated respiratory arrest patient.

Methods: Forty healthcare providers were enrolled and instructed to ventilate a manikin simulating respiratory arrest. Participants were instructed to ventilate the manikin for 5 min with and without the VFD in random order. They were divided in two groups of 20 people, one group ventilating through a mask and the other through an endotracheal tube.

Results: Ventilation with the VFD improved from 15 to 90% (p < 0.001) with the mask and from 15 to 85% (p < 0.001) with the endotracheal tube (ETT) by significantly reducing the proportion of hyperventilation. The mean ventilation rates and tidal volumes were in the recommended ranges in respectively 100% with the mask and 97.5% of participants with the ETT when using the VFD.

Conclusion: VFD improves the performance of manual ventilation by over 70% in different simulated scenarios. By providing the rescuer direct feedback and analysis of ventilatory parameters, this device can significantly improve ventilation while performing CPR and thus save lives.

Keywords: Bag-valve-mask; Cardiac arrest; Manual ventilation; Ventilation feedback device.

Conflict of interest statement

All authors declare that they were involved in the development of the ventilation feedback device which has been subjected to patent application (patent application n° WO 2016/198275). The development of the device has been undertaken by their own organisation under specific public grants.


Fig. 1
Fig. 1
VFD plugged between a self-inflating bag (i.e. manual resuscitator) and a mask
Fig. 2
Fig. 2
Description of the main features of the user interface of the VFD
Fig. 3
Fig. 3
Comparison of mean tidal volume (a) and mean ventilation rate (b) for each participant between conventional ventilation (formula image) and ventilation with VFD (formula image) for BLS and ALS groups. n = 20 participants/group, ventilation was performed during 5 min/participant
Fig. 4
Fig. 4
Comparison of the proportion of hypoventilation (formula image), adequate ventilation (formula image) and hyperventilation (formula image)between conventional manual ventilation and guided ventilation with VFD in the BLS and ALS groups (n = 40 participant

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