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How doctors learn and perform sustained inflations with a self‐inflating bag: a manikin study with a newborn lung simulator
Author(s) -
Boldingh Anne Marthe,
Solevåg Anne L.,
Benth Jūratė Šaltytė,
Klingenberg Claus,
Nakstad Britt
Publication year - 2015
Publication title -
acta paediatrica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.772
H-Index - 115
eISSN - 1651-2227
pISSN - 0803-5253
DOI - 10.1111/apa.12897
Subject(s) - medicine , anesthesia , tidal volume , pulmonary compliance , peak inspiratory pressure , ventilation (architecture) , inflation (cosmology) , positive pressure , lung volumes , resuscitation , lung , respiratory system , mechanical engineering , physics , theoretical physics , engineering
Aim Sustained inflations during initial resuscitation may help a depressed infant make a more efficient transition to air‐filled lungs. This study examined whether doctors could perform sustained inflations with a self‐inflating bag in high and low compliance settings and with an open or blocked pressure‐relief valve. Methods We asked 43 doctors to carry out sustained inflations for more than 5‐sec in a manikin connected to a newborn lung simulator with randomised compliance settings. Tidal volume, inflation time, peak and mean inflating pressure were measured, and 34 were retested 3 months later. Results The majority of the doctors – 72% in the initial study and 62% in the retest – managed sustained inflations within three ventilation attempts, irrespective of lung compliance setting and years of work experience. Using a blocked pressure‐relief valve produced higher tidal volume (27.8 versus 22.6 mL, p < 0.001), inflation time (8.9 versus 8.1 sec, p = 0.025), peak inflating pressure (34.0 versus 28.0 cmH 2 O; p = 0.012) and mean inflating pressure (28.1 versus 22.8 cmH 2 O; p < 0.001). Conclusion The majority of doctors could deliver sustained inflation with a self‐inflating bag in a newborn lung simulator for more than 5‐sec. Using a blocked pressure‐relief valve resulted in higher inflation time, tidal volume and inflation pressure.