Oxygen delivery using a neonatal self-inflating resuscitation bag: effect of oxygen flow.

OBJECTIVE: We evaluated the effect of oxygen (O-2) flow rate on the corresponding delivered fraction of oxygen (FiO(2)) during positive pressure ventilation (PPV) when using a neonatal self-inflating bag (SIB). METHODS: Fifteen health care professionals administered PPV at a respiratory rate of 40 to 60 breaths per minute and at peak inspiratory pressures of 25 and 35 cm H2O to a manikin by using a SIB with reservoir connected to an O-2 source equipped with a flowmeter (flow rates: 0-10 L/min). The FiO(2) corresponding to each flow rate was measured at the inflow to the facial mask for 60 seconds. RESULTS: In total, 2520 FiO(2) data points were collected. At every O-2 flow rate, the FiO(2) gradually increased from time 0 seconds to time 60 seconds, both at 25 cm H2O and at 35 cm H2O. After 1 minute of PPV at 25 cm H2O, the delivered FiO(2) was 31.5% +/- 2.1% and 43.1% +/- 3.1% at O-2 flow rates of 0.1 and 0.5 L/min, respectively. After 1 minute of PPV at 35 cm H2O, the delivered FiO(2) was 29.4% +/- 2.0% and 42.1% +/- 4.6% at O-2 flow rates of 0.1 and 0.5 L/min, respectively. At all O-2 flow rates >5 L/min, the delivered FiO(2) was >85% and >95%, after 1 minute of PPV at 25 and 35 cm H2O, respectively. CONCLUSIONS: Delivered FiO(2) during PPV depends on 3 factors: oxygen flow rate, peak inspiratory pressures, and time elapsed. These data can be used to develop a scheme correlating the oxygen flow rate and the corresponding delivered FiO(2) when using a neonatal SIB. Pediatrics 2013;131:e1144-e1149