title: Oxygen delivery using neonatal self-inflating bags without reservoirs.
abstract: BACKGROUND
  Guidelines recommend avoiding excessive oxygen during neonatal resuscitation. Recent studies have suggested that oxygen titration can be achieved using a self-inflating bag, but data on the effectiveness of resuscitators used in neonatal ventilation are scarce, The aim of this study was therefore to determine the amount of oxygen delivered using several brands of neonatal self-inflating resuscitation bags without reservoirs under different conditions with regard to oxygen flow rate, ventilation rate (VR), peak inspiratory pressure (PIP) range, and test lung compliance.
  
  
  METHODS
  Oxygen concentration was measured under a variety of conditions. Combinations of oxygen flow rate (10, 5.0, 3.0 and 1.0 L/min), VR (40, 60 inflations/min), PIP range (20-25 cmH2O, 35-40 cmH2O), and test lung compliance (0.6, 1.0, 3.0, and 5.0 mL/cmH2O) were examined using six kinds of self-inflating bag.
  
  
  RESULTS
  Delivered oxygen concentration varied widely (30.1-96.7%) and had a significant positive correlation with gas flow rate in all of the bags. Delivered oxygen concentration was also negatively correlated with PIP in all of the bags and with VR in some of them. Test lung compliance did not affect delivered oxygen concentration.
  
  
  CONCLUSIONS
  The use of neonatal resuscitation self-inflating bags without reservoirs resulted in different delivered oxygen concentrations depending on gas flow rate, VR, PIP, and manufacturer, but not on lung compliance. This suggests that targeted oxygen concentrations could be delivered, even in lungs with decreased compliance, during resuscitation.
authors.affiliation: Department of Pediatrics and Neonatology, Shizuoka Saiseikai General Hospital, Shizuoka, Japan.|Committee for Cardiopulmonary Resuscitation of the Japan Society of Fetal and Neonatal Medicine, Tokyo, Japan.
authors.forename: Takahiro
authors.initials: T
authors.lastname: Sugiura
authors.affiliation: Department of Pediatrics and Neonatology, Shizuoka Saiseikai General Hospital, Shizuoka, Japan.
authors.forename: Rei
authors.initials: R
authors.lastname: Urushibata
authors.affiliation: Department of Pediatrics and Neonatology, Shizuoka Saiseikai General Hospital, Shizuoka, Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Komatsu
authors.affiliation: Department of Pediatrics and Neonatology, Shizuoka Saiseikai General Hospital, Shizuoka, Japan.
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Shioda
authors.affiliation: Department of Pediatrics and Neonatology, Shizuoka Saiseikai General Hospital, Shizuoka, Japan.
authors.forename: Tatsuki
authors.initials: T
authors.lastname: Ota
authors.affiliation: Department of Pediatrics and Neonatology, Shizuoka Saiseikai General Hospital, Shizuoka, Japan.
authors.forename: Megumi
authors.initials: M
authors.lastname: Sato
authors.affiliation: Department of Pediatrics and Neonatology, Shizuoka Saiseikai General Hospital, Shizuoka, Japan.
authors.forename: Yumiko
authors.initials: Y
authors.lastname: Okubo
authors.affiliation: Department of Pediatrics and Neonatology, Shizuoka Saiseikai General Hospital, Shizuoka, Japan.
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Fukuoka
authors.affiliation: Department of Pediatrics and Child Health, Nihon University School of Medicine, Tokyo, Japan.|Committee for Cardiopulmonary Resuscitation of the Japan Society of Fetal and Neonatal Medicine, Tokyo, Japan.
authors.forename: Shigeharu
authors.initials: S
authors.lastname: Hosono
authors.affiliation: Committee for Cardiopulmonary Resuscitation of the Japan Society of Fetal and Neonatal Medicine, Tokyo, Japan.|Department of Pediatrics, Saitama Medical Center, Saitama Medical University, Kawagoe, Japan.
authors.forename: Masanori
authors.initials: M
authors.lastname: Tamura
mesh_terms: D006801:Humans; D066298:In Vitro Techniques; D007231:Infant, Newborn; D008170:Lung Compliance; D010100:Oxygen / Q000008:administration & dosage*; D010102:Oxygen Inhalation Therapy / Q000295:instrumentation* / Q000379:methods; D011175:Positive-Pressure Respiration / Q000295:instrumentation* / Q000379:methods
chemical_list: D010100:Oxygen
keywords: lung compliance; newborn; oxygen; positive pressure ventilation; self-inflating bag