Introduction

Failed airway situations are potentially catastrophic events and require a correct approach with appropriate tools. Recently, Ventrain has been presented as a manual device for emergency ventilation through a small-bore cannula, which can provide expiratory assistance by applying the Venturi effect.

Methods

We used the SimulARTI Human Patient Simulator to evaluate Ventrain. Initially, we studied the effectiveness and security in ventilating and oxygenating the patient. In a second phase, the Ventrain performance was compared with what is considered to be the present gold standard (Quicktrach II, Portex Mini-Trach II Seldinger Kit, Melker Emergency Cricothyrotomy Catheter Set). Seven anesthesiologists performed an emergency transcricoid ventilation with each device in the same setting.

Results

Ventrain provided an average tidal volume of 334 ml and an average minute volume of 2.4 l in the considered situation, with a modification of PAO2 from 32 to 702 mmHg and of PACO2 from 54.5 to 38.8 mmHg. In the second phase, the time needed to obtain an effective oxygenation with Ventrain was found to be shorter than other devices (median difference; vs. Minitrach -60 seconds; vs. Melker -35 seconds; vs. Quicktrach -25 seconds) (Figure 1); the ability to remove CO2 resulted bigger (average difference: vs. Minitrach -11.9; vs. Melker -0.3; vs. Quicktrach -5.9) (Figure 2) and moreover the users judged it more favorably.

Figure 1
figure 1

Oxygenation time to oxygen alveolar pressure >100 mmHg.

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Figure 2
figure 2

Mean carbon dioxide alveolar pressure at the start and at the end of the test.

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Conclusion

In this manikin study, Ventrain seemed to be able to appropriately oxygenate and ventilate a patient in a CICV situation. When compared with the best available choices, it has shown not to be inferior.