• Tatiana de Arruda Ortiz, Germano Forti, Márcia Souza Volpe, Marcelo do Amaral Beraldo, AmatoMarcelo Britto PassosMB, CarvalhoCarlos Roberto RibeiroCR, and Mauro Roberto Tucci.
• University of São Paulo, School of Medicine, São Paulo, Brazil.
• J Bras Pneumol. 2013 Sep 1; 39 (5): 595-603.

ObjectiveTo evaluate the performance of manual resuscitators (MRs) used in Brazil in accordance with international standards.MethodsUsing a respiratory system simulator, four volunteer physiotherapists employed eight MRs (five produced in Brazil and three produced abroad), which were tested for inspiratory and expiratory resistance of the patient valve; functioning of the pressure-limiting valve; and tidal volume (VT) generated when the one-handed and two-handed techniques were used. The tests were performed and analyzed in accordance with the American Society for Testing and Materials (ASTM) F920-93 criteria.ResultsExpiratory resistance was greater than 6 cmH2O . L-1 . s-1 in only one MR. The pressure-limiting valve, a feature of five of the MRs, opened at low pressures (< 17 cmH2O), and the maximal pressure was 32.0-55.9 cmH2O. Mean VT varied greatly among the MRs tested. The mean VT values generated with the one-handed technique were lower than the 600 mL recommended by the ASTM. In the situations studied, mean VT was generally lower from the Brazilian-made MRs that had a pressure-limiting valve.ConclusionsThe resistances imposed by the patient valve met the ASTM criteria in all but one of the MRs tested. The pressure-limiting valves of the Brazilian-made MRs usually opened at low pressures, providing lower VT values in the situations studied, especially when the one-handed technique was used, suggesting that both hands should be used and that the pressure-limiting valve should be closed whenever possible.

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