A new physiological manikin to test and compare ventilation devices during cardiopulmonary resuscitation.

Background: There is a lack of bench systems permitting to evaluate ventilation devices in the specific context of cardiac arrest.
Objectives: The objective of the study is to assess if a new physiological manikin may permit to evaluate the performances of medical devices dedicated to ventilation during cardiopulmonary resuscitation (CPR).
Methods: Specific CPR-related features required to reproduce realistic ventilation were implemented into the SAM (Sarthe Anjou Mayenne) manikin. In the first place, the manikin ability to mimic ventilation during CPR was assessed and compared to real-life tracings of airway pressure, flow and capnogram from three out of hospital cardiac arrest (OHCA) patients. In addition, to illustrate the interest of this manikin, ventilation was evaluated during mechanical continuous chest compressions with two devices dedicated to CPR: the Boussignac cardiac arrest device (B-card - Vygon; Ecouen France) and the Impedance Threshold Device (ITD - Zoll; Chelmsford, MA).
Results: The SAM manikin enabled precise replication of ventilation tracings as observed in three OHCA patients during CPR, and it allowed for comparison between two distinct ventilation devices. B-card generated a mean, maximum and minimum intrathoracic pressure of 6.3 (±0.1) cmH ₂ O, 18.9 (±1.1) cmH ₂ O and -0.3 (±0.2) cmH ₂ O respectively; while ITD generated a mean, maximum and minimum intrathoracic pressure of -1.6 (±0.0) cmH ₂ O, 5.7 (±0.1) cmH ₂ O and -4.8 (±0.1) cmH ₂ O respectively during CPR. B-card allowed to increase passive ventilation compared to the ITD which resulted in a dramatic limitation of passive ventilation.
Conclusion: The SAM manikin is an innovative model integrating specific physiological features that permit to accurately evaluate and compare ventilation devices during CPR.
Competing Interests: The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: ‘EF is the co-founder of KerNel Biomedical society who received part of the study fund allocated to this manikin development. AL and LP are medical engineers in the Med2Lab funded by Air Liquide Medical Systems. RC is a physician working for Air Liquide Medical Systems. ML reports part time salary with Air Liquide Medical Systems and KerNel Biomedical. JCR reports part time salary for research activities (Med2Lab) from Air Liquide Medical Systems. FB reports personal consulting fees from Löwenstein Medical and Air Liquide Medical Systems, travel fees from Draeger and Air Liquide Medical Systems and research support from Covidien and GE Healthcare outside this work. FM and DS reports Grants from Fisher and Paykel and travel fees from Air Liquide Medical Systems outside this work. AM reports personal fees from Draeger, Faron Pharmaceuticals, Air Liquide Medical Systems, Pfizer, ResMed and Draeger and grants and personal fees from Fisher & Paykel and Covidien, outside this work. None of the other authors have competing interests related to this topic.’.
(© 2024 The Authors.)