Evaluation of peak inspiratory pressure, tidal volume and respiratory rate during ventilation of premature lambs using a self-inflating bag

Resende, Jefferson G.; Zaconeta, Carlos A. M.; Ferreira, Antonio Celso; Silva, César A. M.; Rodrigues, Marcelo Palmeira; Rebello, Celso Moura; Tavares, Paulo

doi:10.2223/jped.1517

“…Similar findings were reported in two studies conducted by Rezende et al 25,26 that assessed the performance of experienced neonatologists during lung ventilation. These studies evaluated peak pressure, respiratory frequency 25,26 and tidal volume. 26 In both studies, the authors found high variability of values for peak pressure 25,26 and tidal volume.…”

Section: Resultssupporting

confidence: 89%

“…26 In both studies, the authors found high variability of values for peak pressure 25,26 and tidal volume. 26 In addition to high variability, they also observed that the values were often higher than those recommended for neonatal resuscitation, It should also be observed that a source of compressed gas was not used in the present study. Nevertheless, the use of a source of gas connected to a self-inflating bag with oxygen input directly inside the bag may have an important influence on the value of respiratory parameters.…”

Section: Resultsmentioning

confidence: 90%

“…These studies evaluated peak pressure, respiratory frequency 25,26 and tidal volume. 26 In both studies, the authors found high variability of values for peak pressure 25,26 and tidal volume. 26 In addition to high variability, they also observed that the values were often higher than those recommended for neonatal resuscitation, It should also be observed that a source of compressed gas was not used in the present study.…”

Section: Resultsmentioning

confidence: 99%

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Influência do manuseio do balão autoinflável neonatal sobre o pico de pressão e o volume corrente

Bassani¹,

Filho²,

Coppo³

et al. 2009

J. Pediatr. (Rio J.)

6

0

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Objective: To evaluate how different ways of handling the neonatal self-inflating bag influence peak pressure and tidal volume.Methods: This is an experimental study involving 141 different professionals (physicians, resident physicians, physiotherapists, nurses, and nursing technicians), who ventilated an artificial lung, adjusted to simulate the lung of a term neonate, using a self-inflating bag. Each professional handled the ventilator in five different ways: a) using both hands (10 fingers); and, with only one hand, b) five fingers, c) four fingers, d) three fingers, and e) two fingers. Peak pressure and tidal volume data were recorded by the artificial lung equipment.Results: Both variables showed high variability, from 2.5 to 106.3 cmH 2 O (mean = 39.73 cmH 2 O; 95%CI 37.32-42.13) for peak pressure, and from to 4 to 88 mL (mean = 39.56 mL; 95%CI 36.86-42.25) for tidal volume. There was no significant influence of the profession on any of the variables (p > 0.05). However, bag handling significantly influenced both peak pressure and tidal volume (p < 0.0001), which were higher when the operator used both hands. Conclusion:The results indicate that most professionals delivered excessively high peak pressures and tidal volumes, which could increase the risk of barotrauma and volutrauma, especially when both hands were used to ventilate. On the other hand, a small number of professionals delivered insufficient pressure and volume for adequate lung expansion and ventilation. The delivery of inadequate ventilation was not dependent on profession. J Pediatr (Rio J). 2009;85(3):217-222:Neonatal resuscitation, manual lung ventilation, self-inflating bags, barotrauma. No conflicts of interest declared concerning the publication of this article. Original article

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“…It is unclear whether the absolute tidal volumes used affected outcomes. Studies in manikins and animals (LOE 5 63,64 ) suggest that providers cannot maintain constant pressures or assess delivered volume during manual ventilation. The position of the mask and degree of leak may be improved by the use of a volume monitor (LOE 5 65 ).…”

Section: Consensus Of Sciencementioning

confidence: 99%

Part 11: Neonatal Resuscitation

Perlman¹,

Wyllie²,

Kattwinkel³

et al. 2010

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“…Achados semelhantes foram obtidos em dois estudos realizados por Rezende et al 25,26 , nos quais foi avaliado o desempenho de médicos neonatologistas experientes durante a ventilação pulmonar. Foram avaliados pico de pressão, frequência ventilatória 25,26 e volume corrente 26 gerados. Em ambos os estudos, os autores observaram alta variabilidade nos valores obtidos para pico de pressão 25,26 e volume corrente 26 .…”

Section: Discussionunclassified

Peak pressure and tidal volume are affected by how the neonatal self-inflating bag is handled

Bassani

¹

,

Filho

²

,

Coppo

³

et al. 2009

View full text Add to dashboard Cite

Objective: To evaluate how different ways of handling the neonatal self-inflating bag influence peak pressure and tidal volume.Methods: This is an experimental study involving 141 different professionals (physicians, resident physicians, physiotherapists, nurses, and nursing technicians), who ventilated an artificial lung, adjusted to simulate the lung of a term neonate, using a self-inflating bag. Each professional handled the ventilator in five different ways: a) using both hands (10 fingers); and, with only one hand, b) five fingers, c) four fingers, d) three fingers, and e) two fingers. Peak pressure and tidal volume data were recorded by the artificial lung equipment.Results: Both variables showed high variability, from 2.5 to 106.3 cmH 2 O (mean = 39.73 cmH 2 O; 95%CI 37.32-42.13) for peak pressure, and from to 4 to 88 mL (mean = 39.56 mL; 95%CI 36.86-42.25) for tidal volume. There was no significant influence of the profession on any of the variables (p > 0.05). However, bag handling significantly influenced both peak pressure and tidal volume (p < 0.0001), which were higher when the operator used both hands. Conclusion:The results indicate that most professionals delivered excessively high peak pressures and tidal volumes, which could increase the risk of barotrauma and volutrauma, especially when both hands were used to ventilate. On the other hand, a small number of professionals delivered insufficient pressure and volume for adequate lung expansion and ventilation. The delivery of inadequate ventilation was not dependent on profession. J Pediatr (Rio J). 2009;85(3):217-222:Neonatal resuscitation, manual lung ventilation, self-inflating bags, barotrauma. ResumoObjetivo: Avaliar a influência do manuseio do ventilador pulmonar manual neonatal com bolsa autoinflável sobre pico de pressão e volume corrente.Métodos: Estudo experimental com 141 profissionais de saúde (médicos, médicos residentes, fisioterapeutas, enfermeiros e técnicos de enfermagem) que ventilaram um pulmão artificial ajustado para reproduzir o pulmão de um recém-nascido a termo, utilizando ventilador pulmonar manual autoinflável com cinco diferentes modos de manuseio: com as duas mãos (10 dedos) e com uma mão, utilizando cinco, quatro, três e dois dedos. Valores de pico de pressão e volume corrente foram registrados pelo pulmão artificial.Resultados: Observou-se alta variabilidade nos valores das variáveis estudadas. A média do pico de pressão foi 39,73 cmH 2 O (IC95% 37,32-42,13), variando de 2,5 a 106,3 cmH 2 O, e do volume foi 39,56 mL (IC95% 36,86-42,25), variando de 4 a 88 mL. Não foi detectada influência significativa da profissão sobre as variáveis estudadas (p > 0,05). Observou-se que o modo de manuseio do ventilador pulmonar manual influenciou significativamente o pico de pressão e o volume corrente (p < 0,0001), que foram maiores quando o ventilador foi manuseado com as duas mãos. Conclusão:A maioria dos profissionais gerou pico de pressão e volume corrente muito elevados, principalmente quando foram empregadas as duas mã...

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Evaluation of peak inspiratory pressure, tidal volume and respiratory rate during ventilation of premature lambs using a self-inflating bag

Cited by 16 publications

References 18 publications

Influência do manuseio do balão autoinflável neonatal sobre o pico de pressão e o volume corrente

Influência do manuseio do balão autoinflável neonatal sobre o pico de pressão e o volume corrente

Part 11: Neonatal Resuscitation

Peak pressure and tidal volume are affected by how the neonatal self-inflating bag is handled

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