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  • Open Access

Comparison of the Mapleson C circuit, 500 ml and 1.6 l self-inflating bags for delivering guideline-compliant ventilation during simulated adult cardiopulmonary resuscitation

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Critical Care201115 (Suppl 1) :P290

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  • Public Health
  • Survival Rate
  • Clinical Practice
  • Emergency Medicine
  • Healthcare Professional


Despite all the research and education that has gone into the field of cardiopulmonary resuscitation (CPR), survival rates remain bleak. A significant problem has been the discrepancy between teachings and witnessed clinical practice. As a result of this, and the deleterious outcomes associated with hyperventilation, we conducted a manikin-based study to evaluate three different ventilating devices and their ability to provide guideline-compliant ventilation during simulated adult CPR.


A simulated cardiac arrest scenario was undertaken by 33 healthcare professionals (α = 0.05, power = 80%). Participants were asked to ventilate a simulated cardiac arrest patient for a period of 1 minute with all three devices, during which time various ventilatory parameters were recorded using a spirometer. The devices investigated were the Mapleson C circuit, adult (1.6 l) and paediatric (500 ml) self-inflating bags. P < 0.01 was deemed statistical significant, due to multiple comparisons.


The paediatric self-inflating bag performed best, with significant improvement in the mean minute ventilation (P = 0.003), tidal volume (P < 0.001) and peak airway pressure (P < 0.001). Despite the significant differences, the paediatric self-inflating bag still delivered a mean minute ventilation of 7.01 l/minute, which still exceeds the Resuscitation Council's suggested 5 l/minute. See Table 1.
Table 1

Comparison of data on ventilation parameters


500 ml self-inflating bag

1.6 l self-inflating bag

Mapleson C circuit

P value

Minute ventilation (l/minute)

7.01 (3.22)

9.68 (4.22)

9.77 (3.45)


Tidal volume (nl)

391 (51.5)

582 (86.7)

625 (103)

< 0.001*

Respiratory rate (/minute)

16.7 (6.9)

18 (6.45)

17.3 (5.46)


Peak airway pressure (cmH2O)

14.5 (5.18)

20.7 (9.03)

30.3 (11.4)

< 0.001*

Data presented as mean (SD). *Statistically significant result. Nonstatistically significant result.


Participants were found to be hyperventilating simulated cardiac arrest patients with all devices. The paediatric self-inflating bags delivered the most guideline-compliant ventilation and its use in adult CPR may be a simple measure to ensure delivery of more guideline-consistent ventilation.

Authors’ Affiliations

Queens Hospital, Romford, UK


© Sherren et al. 2011

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.