The accuracy of delivery of target pressures using self-inflating bag manometers in a benchtop study

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Abstract

Aim:

We tested whether operators using manometers attached to self-inflating bags could accurately deliver set targeted peak inspiratory pressures (PIPs) compared to the Neopuff™ T-piece resuscitator (TPR).

Methods:

Participants provided positive pressure ventilation to a leak-free neonatal test lung at a rate of 60 inflations/min and a flow of 8 L/min. Participants used three manometers attached to self-inflating bags and a Neopuff™ TPR to target PIPs of 20, 30 and 40 cmH2O on each device. Mean PIPs delivered with each manometer were compared to the ‘gold standard’ Neopuff™ TPR.

Results:

In total, 13 991 inflations delivered by 20 participants were analysed. At all target PIPs, the mean PIP delivered using the Mercury Medical manometer attached to a Laerdal self-inflating bag was significantly higher by 5 cmH2O (p < 0.01) than the Neopuff™ TPR. The PIP delivered using both the Ambu™ and Parker Healthcare manometers attached to their respective devices was similar to that delivered by the Neopuff™ TPR at all targeted PIPs.

Conclusion:

Accurately targeted PIPs can be achieved when a manometer specifically designed for use on a self-inflating bag is used during manual ventilation. This may be useful in settings where access to a Neopuff™ TPR or a gas flow source is limited.

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