title: Evaluation of a novel paediatric self-inflating bag to improve accuracy of tidal volumes delivered during simulated advanced paediatric resuscitation.
abstract: OBJECTIVE
  The aim of the study is to compare the accuracy of manually delivered target tidal volumes (TVs) with the conventional paediatric self-inflating bags (CPBs) versus the novel paediatric self-inflating bags (NPBs) during simulated advanced paediatric resuscitation.
  
  
  METHODS
  Before the trial begun, four target TV ranges were established using the Broselow™ Tape as a reference: 36-70 ml for 6-10 kg, 60-105 ml for 10-15 kg, 90-168 ml for 15-24 kg and 144-210 ml for 24-30 kg. An NPB with four surface marks matching the target TV ranges was prepared. Senior medical students (N=73) were enrolled. After 1 week of training in TV delivery with both CPB and NPB, subjects participated in a test simulation. Using the CPB and NPB in a random cross-over design, participants delivered 10 ventilations to test lungs connected to gas flow analysers for the randomly assigned target TV ranges.
  
  
  RESULTS
  Each of the 730 values for TV and peak inspiratory pressures (PIPs) delivered by CPB and NPB were analysed. The proportion of accurate TV delivery was higher with NPB than with CPB: 84.2% versus 45.9% for 36-70 ml, 93.2% versus 42.7% for 60-105 ml, 96.0% versus 70.3% for 90-168 ml and 91.2% versus 62.6% for 144-210 ml, respectively (all p<0.0001). Compared with NPB, CPB delivery was more varied and was more frequently out of range. There were no significant differences in PIP between the CPB and NPB.
  
  
  CONCLUSIONS
  NPB is useful as a ventilation device for the accurate delivery of TV to small children of varying weights.
authors.affiliation: Department of Emergency Medicine, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea.
authors.forename: Sang O
authors.initials: SO
authors.lastname: Park
authors.forename: Kyeong Ryong
authors.initials: KR
authors.lastname: Lee
authors.forename: Kwang Je
authors.initials: KJ
authors.lastname: Baek
authors.forename: Hye Won
authors.initials: HW
authors.lastname: Shim
authors.forename: Dae Young
authors.initials: DY
authors.lastname: Hong
mesh_terms: D001835:Body Weight; D016887:Cardiopulmonary Resuscitation / Q000295:instrumentation*; D002648:Child; D018592:Cross-Over Studies; D004867:Equipment Design; D006801:Humans; D007327:Insufflation / Q000295:instrumentation; D008348:Manikins; D012121:Respiration, Artificial / Q000295:instrumentation*; D012131:Respiratory Insufficiency / Q000503:physiopathology / Q000628:therapy; D013990:Tidal Volume