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Interventions to improve the mechanical ventilation fidelity of the Laerdal SimMan® 3G simulation mannequin

  • Neil J. Mehta
  • Renee Latoures
  • Martin M. Stechert
  • Richard L. Fidler
  • Jan Hirsch
Correspondence
  • 129 Downloads

To the Editor,

The Laerdal SimMan ® 3G mannequin (Laerdal USA, Wappingers Falls, NY, USA) is widely used for high-fidelity simulation. Nevertheless, providers familiar with mechanical ventilators commonly notice a lower lung compliance, necessitating lower set tidal volumes (V T) to reduce airway pressure. SimMan 3G is 180 cm tall, which corresponds to an ideal body weight of 75 kg (according to http://www.ardsnet.org/tools.shtml) and a V T of 600 mL at 8 mL·kg −1. This “normal” V T without positive end-expiratory pressure (PEEP) results in a peak airway pressure of 34 cmH 2O. For a V T of 500 mL, the peak airway pressure was 28 cmH 2O and the static airway compliance was 24 mL·cmH 2O −1. This static airway compliance of the stock mannequin is about 30-50% of typical human values. 1 These values are reproducible among six SimMan 3G mannequins to which our group has access. Adding PEEP exacerbates problems with high-pressure alarms, and a PEEP above 5 cmH 2O and V Tof 500 mL results in an air leak...

Notes

Conflict of interest

There are no conflicts of interest for any of the authors to disclose.

Disclosure

There are no other associations to disclose.

Editorial responsibility

This submission was handled by Dr. Hilary P. Grocott, Editor-in-Chief, Canadian Journal of Anesthesia.

Funding

There are no external funding sources to disclose.

References

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    Haenel JB, Johnson JL. Mechanical Ventilation in Critical Illness. In: Duke J (Ed.). Anesthesia Secrets, 4th ed. Mosby; 2011: 149-16.Google Scholar
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    Meurling L, Hedman L, Lidefelt KJ, Escher C, Fellander-Tsai L, Wallin CJ. Comparison of high- and low equipment fidelity during paediatric simulation team training: a case control study. BMC Med Educ 2014; 14: 221.CrossRefPubMedPubMedCentralGoogle Scholar
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    Hess DR. Respiratory mechanics in mechanically ventilated patients. Respir Care 2014; 59: 1773-94.CrossRefPubMedGoogle Scholar
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    Henderson WR, Sheel AW. Pulmonary mechanics during mechanical ventilation. Respir Physiol Neurobiol 2012; 180: 162-72.CrossRefPubMedGoogle Scholar

Copyright information

© Canadian Anesthesiologists' Society 2017

Authors and Affiliations

  1. 1.Simulation Center and Anesthesia ServiceSan Francisco VA Medical Center and University of California San FranciscoSan FranciscoUSA

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