Zweiker David, Schwaberger Hanna, Urlesberger Berndt, Mileder Lukas P, Baik-Schneditz Nariae, Pichler Gerhard, Schmölzer Georg M, Schwaberger Bernhard
Division of Neonatology, Department of Pediatrics and Adolescent Medicine, Medical University of Graz, Graz 8010, Austria.
Medizinercorps Graz, Austrian Red Cross Federal Association Styria, Graz 8010, Austria.
Children (Basel). 2018 Sep 21;5(10):132. doi: 10.3390/children5100132.
We sought to compare the effectiveness of two versus five fingers used for bag-valve-mask (BVM) ventilation on effective tidal volume (V) 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 V (five-finger 61.7 ± 23.9 vs. two-finger 58.8 ± 16.6 mL; = 0.35) or ventilatory minute volume (2.71 ± 1.59 vs. 2.76 ± 1.24 L/min; = 0.40) of both BVM ventilation techniques. However, there was an increase in the delivered tidal volume (V) and mask leak when using the five-finger technique compared with the two-finger technique (V 96.1 ± 19.4 vs. 87.7 ± 15.5 mL; < 0.01; and mask leak 34.6 ± 23.0 vs. 30.0 ± 21.0%; = 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 V in an infant resuscitation model.