Oxygen delivery using neonatal self-inflating bags without reservoirs

Area of Science:

• Neonatal resuscitation
• Medical device engineering
• Respiratory physiology

Background:

• Current guidelines advise against excessive oxygen during neonatal resuscitation.
• Limited data exists on the effectiveness of self-inflating bags for neonatal ventilation.
• Oxygen titration is suggested via self-inflating bags, necessitating further investigation.

Purpose of the Study:

• To determine oxygen delivery from neonatal self-inflating resuscitation bags without reservoirs.
• To assess the impact of varying oxygen flow rates, ventilation rates, peak inspiratory pressures, and lung compliance.

Main Methods:

• Evaluated six brands of neonatal self-inflating bags.
• Measured delivered oxygen concentration under diverse conditions.
• Varied oxygen flow rate (1.0-10 L/min), ventilation rate (40-60/min), peak inspiratory pressure (20-40 cmH2O), and lung compliance (0.6-5.0 mL/cmH2O).

Main Results:

• Delivered oxygen concentration ranged widely from 30.1% to 96.7%.
• Positive correlation observed between oxygen concentration and gas flow rate across all bags.
• Negative correlation found between oxygen concentration and peak inspiratory pressure; also with ventilation rate in some bags.
• Lung compliance did not significantly impact delivered oxygen concentration.

Conclusions:

• Neonatal resuscitation bags without reservoirs yield variable oxygen concentrations.
• Delivered oxygen is influenced by gas flow rate, ventilation rate, peak inspiratory pressure, and bag manufacturer.
• Targeted oxygen concentrations are achievable, even with decreased lung compliance, during neonatal resuscitation.