{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,6]],"date-time":"2026-04-06T21:13:28Z","timestamp":1775510008268,"version":"3.50.1"},"reference-count":30,"publisher":"BMJ","issue":"1","funder":[{"name":"Bpi France"},{"name":"European Commission (FEDER) in Franche-Comt\u00e9"},{"name":"Regional Council of Franche-Comt\u00e9"},{"name":"Greater Besan\u00e7on Urban Area Community"},{"name":"General Council of Doubs Department"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open Resp Res"],"published-print":{"date-parts":[[2018,7]]},"abstract":"<jats:sec>\n                  <jats:title>Introduction<\/jats:title>\n                  <jats:p>There is a continuous debate concerning the superiority of endotracheal intubation on bag-valve-mask (BVM) ventilation in patients with cardiac arrest. In this manikin-based observational study, we evaluate and compare the performance of manual ventilation through a facemask (BVM) and an endotracheal tube (ETT).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>One hundred and forty healthcare providers were instructed to manually ventilate a manikin as they would do for a 75\u2009kg adult patient in respiratory arrest. Each one was ventilating both through a facemask and an ETT for a 5\u2009min period in a random order. Ventilatory parameters were measured by the ASL 5000 lung simulator and ventilation performance was analysed using a sliding window method published in a previous study to assess accurately ventilation efficiency.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>The mean ventilation rate was high whatever the technique used (24 bpm). A weak relationship between manual ventilation performance and the type of interface used was observed (p=0.0484). The overall rate of adequate ventilation was low even if we noticed a slight improvement when ventilating through an ETT (13.21% vs 7.5% of adequate ventilation). However, the rate of hyperventilation did not differ between mask and tube (79% vs 77%). A significant relationship is observed between professional category, the size of the hand squeezing the bag and manual ventilation performance (p&lt;0.05).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Whatever the interface used, healthcare professionals are still struggling to perform manual ventilation efficiently according to international guidelines. Ventilation with an ETT does not prove to be significantly more efficient than with a facemask. It would be therefore important to recentre the debate on controlling ventilatory parameters with current devices. Focusing on training may maximise manual ventilation efficiency and minimise the loss of time during cardiopulmonary resuscitation.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/bmjresp-2017-000261","type":"journal-article","created":{"date-parts":[[2018,7,17]],"date-time":"2018-07-17T09:19:13Z","timestamp":1531819153000},"page":"e000261","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":5,"title":["To intubate or not: ventilation is the question. A manikin-based observational study"],"prefix":"10.1136","volume":"5","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8351-0406","authenticated-orcid":false,"given":"Fatimata Seydou","family":"Sall","sequence":"first","affiliation":[{"name":"Inserm CIC 1431, University Hospital of Besan\u00e7on, Besancon, France"},{"name":"Department of Emergency Medicine and Critical Care, University Hospital of Besan\u00e7on, Besan\u00e7on, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alban","family":"De Luca","sequence":"additional","affiliation":[{"name":"Inserm CIC 1431, University Hospital of Besan\u00e7on, Besancon, France"},{"name":"Department of Emergency Medicine and Critical Care, University Hospital of Besan\u00e7on, Besan\u00e7on, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lionel","family":"Pazart","sequence":"additional","affiliation":[{"name":"Inserm CIC 1431, University Hospital of Besan\u00e7on, Besancon, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aurore","family":"Pugin","sequence":"additional","affiliation":[{"name":"Inserm CIC 1431, University Hospital of Besan\u00e7on, Besancon, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gilles","family":"Capellier","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine and Critical Care, University Hospital of Besan\u00e7on, Besan\u00e7on, France"},{"name":"Monash University, Melbourne, Victoria, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abdo","family":"Khoury","sequence":"additional","affiliation":[{"name":"Inserm CIC 1431, University Hospital of Besan\u00e7on, Besancon, France"},{"name":"Department of Emergency Medicine and Critical Care, University Hospital of Besan\u00e7on, Besan\u00e7on, France"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2018,7,17]]},"reference":[{"key":"2025083112275198000_5.1.e000261.1","first-page":"340","article-title":"Peak pressures during manual ventilation","volume":"50","author":"Turki","year":"2005","journal-title":"Respir Care"},{"key":"2025083112275198000_5.1.e000261.2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2044.2001.02090.x"},{"key":"2025083112275198000_5.1.e000261.3","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1002\/pri.196","article-title":"Manual hyperinflation--effects on respiratory parameters","volume":"5","author":"Patman","year":"2000","journal-title":"Physiother Res Int"},{"key":"2025083112275198000_5.1.e000261.4","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm.152.4.7551376"},{"key":"2025083112275198000_5.1.e000261.5","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2044.1993.tb06909.x"},{"key":"2025083112275198000_5.1.e000261.6","doi-asserted-by":"publisher","DOI":"10.1016\/S0300-9572(99)00036-2"},{"key":"2025083112275198000_5.1.e000261.7","doi-asserted-by":"publisher","DOI":"10.1016\/j.resuscitation.2010.08.021"},{"key":"2025083112275198000_5.1.e000261.8","doi-asserted-by":"publisher","DOI":"10.1016\/S0300-9572(98)00068-9"},{"key":"2025083112275198000_5.1.e000261.9","doi-asserted-by":"publisher","DOI":"10.1016\/S0300-9572(99)00118-5"},{"key":"2025083112275198000_5.1.e000261.10","doi-asserted-by":"crossref","first-page":"260","DOI":"10.1213\/01.ANE.0000096190.36875.67","article-title":"Mechanical versus manual ventilation via a face mask during the induction of anesthesia: a prospective, randomized, crossover study","volume":"98","author":"von Goedecke","year":"2004","journal-title":"Anesth Analg"},{"key":"2025083112275198000_5.1.e000261.11","doi-asserted-by":"publisher","DOI":"10.1016\/j.resuscitation.2005.10.007"},{"key":"2025083112275198000_5.1.e000261.12","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajem.2011.07.003"},{"key":"2025083112275198000_5.1.e000261.13","first-page":"2","article-title":"Which is more effective for ventilation in the prehospital setting during cardiopulmonary resuscitation, the laryngeal mask airway or the bag-valve-mask? A review of the literature","volume":"8","author":"Boyle","year":"2012","journal-title":"J Emerg Prim Health Care"},{"key":"2025083112275198000_5.1.e000261.14","doi-asserted-by":"publisher","DOI":"10.1016\/j.resuscitation.2015.06.005"},{"key":"2025083112275198000_5.1.e000261.15","first-page":"308","article-title":"Complications of endotracheal intubation and other airway management procedures","volume":"49","author":"Divatia","year":"2005","journal-title":"Indian J Anaesth"},{"key":"2025083112275198000_5.1.e000261.16","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.110.970988"},{"key":"2025083112275198000_5.1.e000261.17","doi-asserted-by":"publisher","DOI":"10.1155\/2014\/761264"},{"key":"2025083112275198000_5.1.e000261.18","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1155\/2016\/4521767","article-title":"Evaluation of bag-valve-mask ventilation in manikin studies: what are the current limitations?","volume":"2016","author":"Khoury","year":"2016","journal-title":"Biomed Res Int"},{"key":"2025083112275198000_5.1.e000261.19","first-page":"862","article-title":"Comparison of a 10-breaths-per-minute versus a 2-breaths-per-minute strategy during cardiopulmonary resuscitation in a porcine model of cardiac arrest","volume":"53","author":"Lurie","year":"2008","journal-title":"Respir Care"},{"key":"2025083112275198000_5.1.e000261.20","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.0000126594.79136.61"},{"key":"2025083112275198000_5.1.e000261.21","doi-asserted-by":"crossref","first-page":"732","DOI":"10.1016\/j.annemergmed.2012.06.017","article-title":"Balancing the potential risks and benefits of out-of-hospital intubation in traumatic brain injury: the intubation\/hyperventilation effect","volume":"60","author":"Gaither","year":"2012","journal-title":"Ann Emerg Med"},{"key":"2025083112275198000_5.1.e000261.22","doi-asserted-by":"publisher","DOI":"10.1016\/j.resuscitation.2015.07.041"},{"key":"2025083112275198000_5.1.e000261.23","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000259"},{"key":"2025083112275198000_5.1.e000261.24","doi-asserted-by":"publisher","DOI":"10.1016\/j.resuscitation.2006.09.012"},{"key":"2025083112275198000_5.1.e000261.25","doi-asserted-by":"crossref","first-page":"749","DOI":"10.5811\/westjem.2014.9.20291","article-title":"Does pre-hospital endotracheal intubation improve survival in adults with non-traumatic out-of-hospital cardiac arrest? A systematic review","volume":"15","author":"Tiah","year":"2014","journal-title":"West J Emerg Med"},{"key":"2025083112275198000_5.1.e000261.26","doi-asserted-by":"publisher","DOI":"10.1016\/j.annemergmed.2006.01.016"},{"key":"2025083112275198000_5.1.e000261.27","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.292.6514.157"},{"key":"2025083112275198000_5.1.e000261.28","doi-asserted-by":"publisher","DOI":"10.1213\/01.ane.0000253523.80050.e9"},{"key":"2025083112275198000_5.1.e000261.29","doi-asserted-by":"publisher","DOI":"10.1111\/j.1553-2712.2010.00829.x"},{"key":"2025083112275198000_5.1.e000261.30","doi-asserted-by":"crossref","first-page":"1399","DOI":"10.1111\/anae.13526","article-title":"Man vs. manikin revisited - the ethical boundaries of simulating difficult airways in patients","volume":"71","author":"Ward","year":"2016","journal-title":"Anaesthesia"}],"container-title":["BMJ Open Respiratory Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjresp-2017-000261","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,31]],"date-time":"2025-08-31T19:28:02Z","timestamp":1756668482000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopenrespres.bmj.com\/lookup\/doi\/10.1136\/bmjresp-2017-000261"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,7]]},"references-count":30,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2018,7,17]]},"published-print":{"date-parts":[[2018,7]]}},"alternative-id":["10.1136\/bmjresp-2017-000261"],"URL":"https:\/\/doi.org\/10.1136\/bmjresp-2017-000261","relation":{},"ISSN":["2052-4439"],"issn-type":[{"value":"2052-4439","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,7]]}}}