title: Manual Ventilation and Sustained Lung Inflation in an Experimental Model: Influence of Equipment Type and Operator's Training.
abstract: OBJECTIVE
  To compare the influence of devices for manual ventilation and individual experience on the applied respiratory mechanics and sustained lung inflation.
  
  
  METHODS
  A total of 114 instructors and non-instructors from the Neonatal Resuscitation Program of the Brazilian Society of Pediatrics participated in this study. Participants ventilated an intubated manikin. To evaluate respiratory mechanics and sustained lung inflation parameters, a direct comparison was made between the self-inflating bag and the T-shaped resuscitator (T-piece), followed by an analysis of the effectiveness of the equipment according to the participants' education and training.
  
  
  RESULTS
  A difference between equipment types was observed for the tidal volume, with a median (interquartile range) of 28.5 mL (12.6) for the self-inflating bag and 20.1 mL (8.4) for the T-piece in the instructor group and 31.6 mL (14) for the self-inflating bag and 22.3 mL (8.8) for the T-piece in the non-instructor group. Higher inspiratory time values were observed with the T-piece in both groups of professionals, with no significant difference between them. The operator's ability to maintain the target pressure over the 10 seconds of sustained lung inflation was evaluated using the area under the pressure-time curve and was 1.7-fold higher with the use of the T-piece. Inspiratory pressure and mean airway pressure applied during sustained lung inflation were greater with the self-inflating bag, as evaluated between the beginning and the end of the procedure.
  
  
  CONCLUSIONS
  The T-piece resulted in lower tidal volume and higher inspiratory time values, irrespective of the operator's experience, and increased the ease of performing the sustained lung inflation maneuver, as demonstrated by the maintenance of target pressure for the desired period and a higher mean airway pressure than that obtained using the self-inflating bag.
authors: Department of Pediatrics, School of Medicine, University of Sao Paulo, Sao Paulo, Sao Paulo, Brazil.|Department of Pediatrics, Hospital Israelita Albert Einstein, Sao Paulo, Sao Paulo, Brazil.
authors: Cristiane
authors: C
authors: do Prado
authors: Brazilian Society of Pediatrics, Neonatal Resuscitation Program, Sao Paulo, Sao Paulo, Brazil.|Department of Pediatrics, Paulista School of Medicine, Federal University of Sao Paulo, Sao Paulo, Sao Paulo, Brazil.
authors: Ruth
authors: R
authors: Guinsburg
authors: Brazilian Society of Pediatrics, Neonatal Resuscitation Program, Sao Paulo, Sao Paulo, Brazil.|Department of Pediatrics, Paulista School of Medicine, Federal University of Sao Paulo, Sao Paulo, Sao Paulo, Brazil.
authors: Maria Fernanda Branco
authors: MF
authors: de Almeida
authors: Department of Pediatrics, Hospital da Vila Santa Catarina, Sao Paulo, Sao Paulo, Brazil.
authors: Renata Suman
authors: RS
authors: Mascaretti
authors: Department of Pediatrics, Hospital Israelita Albert Einstein, Sao Paulo, Sao Paulo, Brazil.
authors: Luciana Assis
authors: LA
authors: Vale
authors: Department of Pediatrics, Hospital Israelita Albert Einstein, Sao Paulo, Sao Paulo, Brazil.
authors: Luciana Branco
authors: LB
authors: Haddad
authors: Department of Pediatrics, School of Medicine, University of Sao Paulo, Sao Paulo, Sao Paulo, Brazil.|Department of Pediatrics, Hospital Israelita Albert Einstein, Sao Paulo, Sao Paulo, Brazil.
authors: Celso Moura
authors: CM
authors: Rebello
mesh_terms: D001938:Brazil; D004867:Equipment Design; D006801:Humans; D007231:Infant, Newborn; D008348:Manikins; D008954:Models, Biological; D008962:Models, Theoretical; D011175:Positive-Pressure Respiration / Q000295:instrumentation / Q000379:methods; D012121:Respiration, Artificial / Q000295:instrumentation / Q000379:methods*; D015656:Respiratory Mechanics; D012151:Resuscitation / Q000193:education / Q000295:instrumentation / Q000379:methods*; D013990:Tidal Volume