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Newborn manikin study shows that physicians often fail to detect correct lung compliance when using a self‐inflating bag
Author(s) -
Boldingh Anne Marthe,
Solevåg Anne Lee,
Benth Jūratė Šaltytė,
Klingenberg Claus,
Nakstad Britt
Publication year - 2016
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.13114
Subject(s) - medicine , compliance (psychology) , pulmonary compliance , ventilation (architecture) , intervention (counseling) , physical therapy , cardiopulmonary resuscitation , emergency medicine , resuscitation , lung , nursing , psychology , social psychology , mechanical engineering , engineering
Aim Recognising changes in lung compliance can help clinicians to adjust initial inflations during resuscitation at birth. We examined whether physicians sensed low and normal compliance with a self‐inflating bag before and after an educational intervention that used a manikin connected to a newborn lung simulator. Methods We asked 43 physicians with neonatal duties to perform two low compliance ventilation attempts and two normal‐compliance ventilation attempts in a randomised order at baseline and after the educational intervention, with 34 taking part in a retest three months later. Results The physicians correctly recognised low and normal compliance in 71% and 66% of the ventilations at baseline, 80% and 66% of the ventilations after the intervention and 74% and 81% at retest. Correct recognition of normal compliance improved from baseline to retest (p = 0.04). Ventilations in low‐ vs normal‐compliance settings resulted in lower tidal volumes (4.4 vs 23.0 mL, p < 0.001), lower ventilation rates (42 vs 51, p < 0.001) and higher peak inflating pressure (35.2 vs 31.4 cmH 2 O, p < 0.001). Conclusion Around one in four physicians failed to recognise correct compliance levels when using a self‐inflating bag and showed limited improvement after an educational intervention. Ventilations in a low‐compliance setting resulted in suboptimal ventilation.