Universidade Estadual de Campinas, Campinas, São Paulo, Brazil.
Respir Care. 2012 Apr;57(4):525-30. doi: 10.4187/respcare.01423. Epub 2011 Oct 13.
Although the self-inflating bag is widely used in the hospital setting, variability of delivered ventilatory parameters is usually high, which might result in both hypoventilation and lung injury. The aims of this study were to assess possible sources of the high variability and to evaluate the adequacy of obtained values in relation to the recommended values for neonatal resuscitation.
This was an experimental study in which 172 health professionals (physicians, resident physicians, physiotherapists, nurses, and nursing technicians) who work with neonatal intensive care manually ventilated a test lung (adjusted to simulate the lungs of an intubated term newborn) with a self-inflating bag in 5 different handling techniques, using 10, 5, 4, 3, and 2 fingers. Delivered values of peak inspiratory pressure (PIP), tidal volume (V(T)), and ventilatory frequency (f) were compared, taking into account the different handling modalities and professions by analysis of variance for repeated measures. Chi-square, the Friedman test and the Fisher exact tests were performed to compare the delivered and standard values.
PIP and V(T) were significantly affected by the handling technique, with higher values for a greater number of fingers used for ventilation. Profession also influenced V(T) and f significantly: physiotherapists tended to deliver higher volumes and lower rates. Nevertheless, we observed high variability of all studied ventilatory parameters and overall inadequacy of obtained values. Most volunteers delivered excessive pressures and volumes at insufficient ventilatory frequency.
Delivered values seem to depend on operators' individual and professional differences, as well as on the number of fingers used to compress the bag. However, from the clinical point of view, it is important to point out the high occurrence of inadequate delivered values, regardless of handling technique and profession.
尽管自动充气袋在医院环境中被广泛使用，但输送的通气参数通常变化很大，这可能导致通气不足和肺损伤。本研究的目的是评估高变异性的可能来源，并评估获得的值与新生儿复苏推荐值的相关性。
这是一项实验研究，其中 172 名从事新生儿重症监护的健康专业人员（医生、住院医师、物理治疗师、护士和护理技师）使用自动充气袋以 5 种不同的处理技术手动通气测试肺（调整以模拟气管内足月新生儿的肺），使用 10、5、4、3 和 2 根手指。通过重复测量方差分析比较不同处理方式和职业的峰压（PIP）、潮气量（V（T））和通气频率（f）的输送值。进行卡方检验、弗里德曼检验和 Fisher 确切检验，以比较输送值和标准值。
PIP 和 V（T）受处理技术影响显著，使用更多手指通气时值更高。职业也显著影响 V（T）和 f：物理治疗师倾向于输送更高的体积和更低的速率。然而，我们观察到所有研究通气参数的高度变异性和总体获得值不足。大多数志愿者在不足的通气频率下输送过高的压力和体积。
输送值似乎取决于操作人员的个体和专业差异，以及用于压缩袋的手指数量。然而，从临床角度来看，重要的是要指出，无论处理技术和职业如何，输送值不足的情况都很常见。
