title: Neonatal and pediatric manual hyperinflation: influence of oxygen flow on ventilation parameters.
abstract: BACKGROUND
  Although self-inflating bags are widely used for manual hyperinflation, they do not allow ventilation parameters, such as pressure or volume, to be set. We studied the ventilation performance of neonatal and pediatric self-inflating bags.
  
  
  METHODS
  We asked 22 physiotherapists to manually hyperinflate 2 lung models (neonatal and pediatric), using self-inflating bags from 3 manufactures (Hudson, Laerdal, and JG Moriya), with flows of 0, 5, 10, and 15 L/min. A pneumotachograph recorded tidal volume (V(T)), peak inspiratory pressure (PIP), peak inspiratory flow (PIF), peak expiratory flow (PEF), and inspiratory time.
  
  
  RESULTS
  The V(T), PIP, and inspiratory time delivered by the Hudson, Laerdal, and JG Moriya bags, in both neonatal and pediatric self-inflating bags, were significantly different (P < .001). The PEF and PIF delivered were different only when using the neonatal self-inflating bags (P < .001). The V(T), PIP, and PIF delivered with a flow of 0 L/min were lower than with 15 L/min (P < .05) with all the tested bags, in both the neonatal and pediatric sizes.
  
  
  CONCLUSIONS
  The performance of the tested neonatal and pediatric bags varied by manufacturer and oxygen flow. There was an increase in VT, PIP, and PIF related to the increase of oxygen flow from 0 L/min to 15 L/min. The neonatal bags showed higher ventilation parameters variation than the pediatric bags.
authors.affiliation: Department of Pediatrics, Faculty of Medical Sciences.
authors.forename: Pricila Mara Novais
authors.initials: PM
authors.lastname: de Oliveira
authors.forename: Armando Augusto
authors.initials: AA
authors.lastname: Almeida-Junior
authors.forename: Celize Cruz Bresciani
authors.initials: CC
authors.lastname: Almeida
authors.forename: Maria Ângela Gonçalves
authors.initials: MÂ
authors.lastname: de Oliveira Ribeiro
authors.forename: José Dirceu
authors.initials: JD
authors.lastname: Ribeiro
mesh_terms: D002648:Child; D057186:Comparative Effectiveness Research; D003198:Computer Simulation; D004867:Equipment Design; D006801:Humans; D007231:Infant, Newborn; D008176:Lung Volume Measurements / Q000379:methods; D008954:Models, Biological; D008991:Monitoring, Physiologic; D010100:Oxygen / Q000008:administration & dosage; D010102:Oxygen Inhalation Therapy / Q000295:instrumentation / Q000379:methods; D010372:Pediatrics / Q000295:instrumentation / Q000379:methods; D011175:Positive-Pressure Respiration / Q000295:instrumentation / Q000379:methods; D011897:Random Allocation; D012129:Respiratory Function Tests / Q000379:methods; D012151:Resuscitation / Q000295:instrumentation*; D012122:Ventilators, Mechanical / Q000592:standards*
chemical_list: D010100:Oxygen
keywords: manual hyperinflation; pediatric; respiratory function monitor; respiratory therapy; resuscitation; self-inflating bag