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

Acta Paediatr. 2016 Jun;105(6):e247-51. doi: 10.1111/apa.13397.

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 cmH2 O 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 cmH2 O (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.

Keywords: Low-resource; Manometer; Neonate; Resuscitation; Self-inflating bag.

MeSH terms

  • Manometry / statistics & numerical data*
  • Positive-Pressure Respiration / instrumentation
  • Positive-Pressure Respiration / statistics & numerical data*