A Comparison of the T-Piece,Venturi T-Piece and T-Bag for Emergence with the Laryngeal Mask

Abstract

We have compared the performance of a standard T-piece, a Venturi T-piece and a T-bag (T-piece with a small reservoir bag) for emergence with the laryngeal mask airway in 20 awake volunteers. FiO₂, ETCO₂ and FiCO₂ were measured at oxygen flow rates of 2, 4 and 6 l.min^-1 during three different breathing patterns: normal tidal volume, respiratory rate 12 .min^-1; normal tidal volume, respiratory rate 20 .min^-1; high tidal volume, respirutory rate 12 .min^-1. The T-piece and T-bag delivered a higher overall average FiO₂ than the Venturi T-piece (P<0.00001). Compared with normal breathing, FiO₂ was reduced at the higher respiratory rate and tidal volume with the T-piece and T-bag hut was not reduced with the Venturi T-piece. FiO₂ increased with increasing flow rates for all devices except the Venturi T-piece during normal breathing. ETCO₂ was higher during normal breathing (4.4±0.0%) compared with higher respiratory rate (3.7±0.9%) and tidal volume (3.4±0.7%) for all devices. There were no differences in overall ETCO₂ between devices. The FiCO₂ was never higher than 0.2% in any subject. We conclude that the T-piece and T-bag are more effective oxygen enrichment devices than the Venturi T-piece. The T-bag provides a useful visual signal about depth and frequency of respiration.