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Resuscitation. 2005 Oct;67(1):109-12.

Use of self-inflating bags for neonatal resuscitation.

Author information

1
Consultant Neonatologist, Bradford Royal Infirmary, Duckworth Lane, Bradford BD9 6RJ, UK. Sam.Oddie@bradfordhospitals.nhs.uk

Abstract

BACKGROUND:

Lung inflation is the most important, and most difficult step in newborn resuscitation. A wide variety of devices are used to achieve lung inflation, but there are relatively few data to guide clinicians in their choice of device.

METHODS:

We tested the ability of instructors and trained candidates on a newborn life support course to deliver initial inflation breaths to a test lung, using a pressure limited blow-off valve, a 240-ml self-inflating bag and a 500-ml self-inflating bag in sequence.

RESULTS:

Use of a 240-ml self-inflating bag was associated with shorter initial inflations of 1.8 s mean (95% CI 1.60-1.99 s), compared with 2.42 s (2.24-2.61 s), 2.40 s (2.08-2.71 s) for 500-ml self-inflating bags and "Tom Thumb" T piece, respectively. Delivery of breaths within a target pressure range of 30+/-5 cm H2O was significantly better using a T piece than either self-inflating bag (proportion within target range 0.05 (95% CI 0-0.11), 0.17 (95% CI 0.12-0.23), 0.89 (95% CI 0.83-0.94) for 240-ml and 500-ml self-inflating bags and "Tom Thumb" T piece, respectively. Excessive pressure delivery with both sizes of self-inflating bag was frequent.

CONCLUSIONS:

These data do not support use of 240-ml or 500-ml self-inflating bags for resuscitation of newborn term infants. A variable pressure T piece blow-off system may be the easiest device to use for newborn resuscitation and the most reliable at delivering desired pressures for set times.

[Indexed for MEDLINE]

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