No abstract

Ventilation rates achieved with the self-inflating bag were adequate in approximately 80% of pressure curves analyzed, but the physicians were unable to provide ventilation with minimal pressure variation, producing pressures that diverged from those defined by the neonatal resuscitation training course in 70% of the curves. This was irrespective of whether they were ventilating the lung model analogous to preterm or full term infant lungs.

Objective: To evaluate the peak inspiratory pressure, tidal volume and respiratory rate achieved during manual ventilation of premature lambs, using a self-inflating bag.Methods: In this descriptive, experimental study, five pairs of physicians, selected at random among 35 neonatologists working at a neonatal intensive care unit and with experience in the resuscitation of newborn infants, ventilated five intubated premature lambs using a self-inflating bag. Pressure and flow monitor signals were passed through a transducer and digitized for recording and analysis. Tidal volume and pressure curves were obtained from the integral of flow rate, at peak, during the last 50 seconds of every fifth minute, and analyzed.Results: Median pressure was 39.8 (IQ 25-75% 30.2-47.2) cmH 2 O; being below 20 in 1.1% of cases and above 40 in 49.1%. Seven out of 10 physicians produced more than six pressure peaks of over 40 cmH 2 O. Median tidal volume/kg was 17.8 (IQ 25-75% 14.1-22.4) mL, being below 5 mL in 0.1% of cases and greater than or equal to 20 mL in 37.7%. All of the physicians propelled five or more ventilation cycles with tidal volume/kg of 20 mL or more. Respiratory rate was between 30 and 60 cycles/minute in 65.9% of cases, being below 30 in 6.8% of cases and over 60 in 27.3% of cases.Conclusions: There was major variation in peak inspiratory pressure and tidal volume/kg values, which were in many cases elevated, attaining levels that habitually cause biotrauma, while respiratory rates were adequate in the majority of cases. J Pediatr (Rio J) ARTIGO ORIGINAL

Objective: To evaluate the peak inspiratory pressure and ventilation rate achieved by physicians when using a neonatal self-inflating bag on a lung model. Methods: Fifteen physicians ventilated full term and preterm infant lung simulators while the outcomes were captured by a ventilation monitor.Results: Median peak pressures in cmH 2 O for full term and preterm lungs were 23 (interquartile range: 15-47) and 26 (interquartile range: 14-51), being less than 20 in 41.2 and 35.8% of the pressure curves analyzed, more than 40 in 29.7 and 33.6%, and between 27 and 33 cmH 2 O in 8.2 and 6.5% of the curves, respectively. Median ventilation rates were 45 (interquartile range: 36-57) and 48 (interquartile range: 39-55.5) cycles per minute, being more than 30 in 9.3 and 6.7% of pressure curves and more than 60 in 12 and 13.3% of pressure curves, for the full term and preterm lungs, respectively. The differences between these medians were not statistically significant.Conclusions: Ventilation rates achieved with the self-inflating bag were adequate in approximately 80% of pressure curves analyzed, but the physicians were unable to provide ventilation with minimal pressure variation, producing pressures that diverged from those defined by the neonatal resuscitation training course in 70% of the curves. This was irrespective of whether they were ventilating the lung model analogous to preterm or full term infant lungs.

Objective: To evaluate the peak inspiratory pressure, tidal volume and respiratory rate achieved during manual ventilation of premature lambs, using a self-inflating bag. Methods:In this descriptive, experimental study, five pairs of physicians, selected at random among 35 neonatologists working at a neonatal intensive care unit and with experience in the resuscitation of newborn infants, ventilated five intubated premature lambs using a self-inflating bag. Pressure and flow monitor signals were passed through a transducer and digitized for recording and analysis. Tidal volume and pressure curves were obtained from the integral of flow rate, at peak, during the last 50 seconds of every fifth minute, and analyzed.Results: Median pressure was 39.8 (IQ 25-75% 30.2-47.2) cmH 2 O; being below 20 in 1.1% of cases and above 40 in 49.1%. Seven out of 10 physicians produced more than six pressure peaks of over 40 cmH 2 O. Median tidal volume/kg was 17.8 (IQ 25-75% 14.1-22.4) mL, being below 5 mL in 0.1% of cases and greater than or equal to 20 mL in 37.7%. All of the physicians propelled five or more ventilation cycles with tidal volume/kg of 20 mL or more. Respiratory rate was between 30 and 60 cycles/minute in 65.9% of cases, being below 30 in 6.8% of cases and over 60 in 27.3% of cases.Conclusions: There was major variation in peak inspiratory pressure and tidal volume/kg values, which were in many cases elevated, attaining levels that habitually cause biotrauma, while respiratory rates were adequate in the majority of cases.