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Children 2018, 5(10), 132; https://doi.org/10.3390/children5100132

Does the Number of Fingers on the Bag Influence Volume Delivery? A Randomized Model Study of Bag-Valve-Mask Ventilation in Infants

1
Division of Neonatology, Department of Pediatrics and Adolescent Medicine, Medical University of Graz, Graz 8010, Austria
2
Medizinercorps Graz, Austrian Red Cross Federal Association Styria, Graz 8010, Austria
3
Centre for the Studies of Asphyxia and Resuscitation, Neonatal Research Unit, Royal Alexandra Hospital, Edmonton, AB T5H 3V9, Canada
4
Department of Pediatrics, University of Alberta, Edmonton, AB T6G 1C9, Canada
*
Author to whom correspondence should be addressed.
Received: 13 August 2018 / Revised: 14 September 2018 / Accepted: 17 September 2018 / Published: 21 September 2018
(This article belongs to the Special Issue Emerging Concepts in Neonatal Resuscitation)
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Abstract

We sought to compare the effectiveness of two versus five fingers used for bag-valve-mask (BVM) ventilation on effective tidal volume (VTeff) delivery in an infant resuscitation model. In a randomised cross-over study, 40 healthcare professionals ventilated a modified leak-free infant resuscitation manikin with both two and five fingers, using a self-inflating bag. The delivered and effective tidal volumes, ventilation rate, and mask leak were measured and recorded using a respiratory function monitor. We found no significant differences in the VTeff (five-finger 61.7 ± 23.9 vs. two-finger 58.8 ± 16.6 mL; p = 0.35) or ventilatory minute volume (2.71 ± 1.59 vs. 2.76 ± 1.24 L/min; p = 0.40) of both BVM ventilation techniques. However, there was an increase in the delivered tidal volume (VTdel) and mask leak when using the five-finger technique compared with the two-finger technique (VTdel 96.1 ± 19.4 vs. 87.7 ± 15.5 mL; p < 0.01; and mask leak 34.6 ± 23.0 vs. 30.0 ± 21.0%; p = 0.02). Although the five-finger technique was associated with an increased mask leak, the number of fingers used during the BVM ventilation had no effect on VTeff in an infant resuscitation model. View Full-Text
Keywords: paediatric resuscitation; ventilation; non-invasive; mask ventilation; bag-valve-mask ventilation; ventilation technique paediatric resuscitation; ventilation; non-invasive; mask ventilation; bag-valve-mask ventilation; ventilation technique
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Zweiker, D.; Schwaberger, H.; Urlesberger, B.; Mileder, L.P.; Baik-Schneditz, N.; Pichler, G.; Schmölzer, G.M.; Schwaberger, B. Does the Number of Fingers on the Bag Influence Volume Delivery? A Randomized Model Study of Bag-Valve-Mask Ventilation in Infants. Children 2018, 5, 132.

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