Soltesz, S., Alm, P., Mathes, A., Hellmich, M. and Hinkelbein, J. (2017). The effect of neuromuscular blockade on the efficiency of facemask ventilation in patients difficult to facemask ventilate: a prospective trial. Anaesthesia, 72 (12). S. 1484 - 1491. HOBOKEN: WILEY. ISSN 1365-2044

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Abstract

Facemask ventilation of the lungs can be an important rescue intervention in a cannot intubate' scenario. We assessed the effect of neuromuscular blockade on expiratory tidal volumes in patients with expected difficulty in mask ventilation. The lungs of patients with at least three predictors of difficulty in mask ventilation were ventilated using a facemask held with two hands, with mechanical ventilation set in a pressure-controlled mode. Tidal volumes were recorded before and after the establishment of complete neuromuscular block. In 113 patients, median (IQR [range]) tidal volume increased from 350 (260-492 [80-850]) ml initially, by 48% to 517 (373-667 [100-1250]) ml 30 s after rocuronium administration, (p < 0.001). After the onset of the complete neuromuscular block, a median tidal volume of 600 (433-750 [250-1303]) ml was observed, corresponding to an increase of 71% from baseline values (p < 0.001), and 16% from values obtained 30 s after rocuronium administration, respectively; p = 0.003). No decrease in the tidal volume during the measurements was observed. We conclude that the administration of rocuronium at a dose of 0.6 mg.kg(-1) was able to improve facemask ventilation in all cases with a potentially clinically relevant increase in tidal volume. The early use of a neuromuscular blocking agent can be considered as a therapeutic option in case of difficulty with mask ventilation.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Soltesz, S.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Alm, P.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Mathes, A.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hellmich, M.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hinkelbein, J.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-210549
DOI: 10.1111/anae.14035
Journal or Publication Title: Anaesthesia
Volume: 72
Number: 12
Page Range: S. 1484 - 1491
Date: 2017
Publisher: WILEY
Place of Publication: HOBOKEN
ISSN: 1365-2044
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
IMPOSSIBLE MASK VENTILATION; BLOCKING-DRUGS; AIRWAY; PREDICTION; ANESTHESIAMultiple languages
AnesthesiologyMultiple languages
Refereed: Yes
URI: http://kups.ub.uni-koeln.de/id/eprint/21054

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