RT Journal Article
SR Electronic
T1 An Evaluation of Peak Inspiratory Pressure, Tidal Volume, and Ventilatory Frequency During Ventilation With a Neonatal Self-Inflating Bag Resuscitator
JF Respiratory Care
FD American Association for Respiratory Care
SP 525
OP 530
DO 10.4187/respcare.01423
VO 57
IS 4
A1 Mariana Almada Bassani
A1 Francisco Mezzacappa Filho
A1 Maria Regina de Carvalho Coppo
A1 Sérgio Tadeu Martins Marba
YR 2012
UL http://rc.rcjournal.com/content/57/4/525.abstract
AB BACKGROUND: Although the self-inflating bag is widely used in the hospital setting, variability of delivered ventilatory parameters is usually high, which might result in both hypoventilation and lung injury. The aims of this study were to assess possible sources of the high variability and to evaluate the adequacy of obtained values in relation to the recommended values for neonatal resuscitation. METHODS: This was an experimental study in which 172 health professionals (physicians, resident physicians, physiotherapists, nurses, and nursing technicians) who work with neonatal intensive care manually ventilated a test lung (adjusted to simulate the lungs of an intubated term newborn) with a self-inflating bag in 5 different handling techniques, using 10, 5, 4, 3, and 2 fingers. Delivered values of peak inspiratory pressure (PIP), tidal volume (VT), and ventilatory frequency (f) were compared, taking into account the different handling modalities and professions by analysis of variance for repeated measures. Chi-square, the Friedman test and the Fisher exact tests were performed to compare the delivered and standard values. RESULTS: PIP and VT were significantly affected by the handling technique, with higher values for a greater number of fingers used for ventilation. Profession also influenced VT and f significantly: physiotherapists tended to deliver higher volumes and lower rates. Nevertheless, we observed high variability of all studied ventilatory parameters and overall inadequacy of obtained values. Most volunteers delivered excessive pressures and volumes at insufficient ventilatory frequency. CONCLUSIONS: Delivered values seem to depend on operators' individual and professional differences, as well as on the number of fingers used to compress the bag. However, from the clinical point of view, it is important to point out the high occurrence of inadequate delivered values, regardless of handling technique and profession.