Efficacy of Amflow®, a Real-Time-Portable Feedback Device for Delivering Appropriate Ventilation in Critically Ill Patients: A Randomised, Controlled, Cross-Over Simulation Study.

Objective. The aim of this study was to test whether Amflow (R) (a newly designed portable ventilation feedback device) can assist rescuers in delivering target tidal volume (VT) and respiration rate (RR) during self-inflating bag (SB) ventilations in various clinical scenarios. Method. This was a simulation study with a prospective cross-over design. A total of 40 trained participants who underwent training for SB ventilation were recruited. Using a SB with or without Amflow (R) alternately, participants delivered ventilations to test lungs connected to a gas flow analyser in each of three different scenarios: acute respiratory distress syndrome (ARDS; 315-385 ml ranges for 350 ml target VT, with 20 breaths/min); cardiopulmonary resuscitation (CPR; 450-550 ml ranges for 500 ml target VT with 10 breaths/min); and adult head trauma (630-770 ml ranges for 700 ml target VT with 15 breaths/min). Results. The feedback group (SB with Amflow (R)) demonstrated a significantly higher percentage of delivering the appropriate VT ranges than the no-feedback group for both ARDS (58.6% versus 23.5%, respectively) and CPR (85.4% versus 41.0%, respectively) (all p<0.05). However, there was no significant difference between the two groups in the percentage of delivering the appropriate VT ranges in head trauma patients (65.9% versus 68.3%, respectively; p=0.092). In all three scenarios, a higher percentage of target RR delivered was achieved in the feedback group (88.3%, 99.2%, and 96.3%, respectively) compared with the no-feedback group (5.8%, 12.5%, and 10.0%, respectively) (all p<0.05). Conclusion. The Amflow (R) device could be useful for rescuers in delivering SB ventilation with appropriate VT and RR simultaneously in various critical situations, except for clinical cases that demand greater delivered VT.