Abstract
Background
Self-inflating resuscitators (SIRs) are often used in pediatric resuscitation. Improper
setup of the SIR can lead to inadequate ventilation and oxygenation.
Objectives
To present clinical scenarios in which SIRs delivered inadequate tidal volumes due
to improper use. Second, to evaluate tidal volumes delivered using SIRs at varying
lung compliances with the manometer and pop-off valve port open and closed. Third,
to suggest methods to overcome improper use.
Methods
Five pediatric resuscitators were tested under conditions simulating normal lungs,
lungs with moderately decreased compliance, and lungs with poor compliance (0.015,
0.010, and 0.005 L/cm H2O, respectively) to determine volumes delivered with proper SIR setup (manometer and
pop-off valve closed) and improper SIR setup (manometer or pop-off valve open).
Results
With each SIR, an open manometer port or an open pop-off valve (improper setup) led
to significant decreases in volume delivered. In normal lung compliance, the proper
setup delivered 149 ± 10 cc, vs. 112 ± 12 cc, 106 ± 25 cc, and 90 ± 14 cc (pop-off
open, manometer open, and both open, respectively). In poor lung compliance, the proper
setup delivered 122 ± 13 cc, vs. 56 ± 10 cc, 70 ± 17 cc, and 44 ± 7 cc (pop-off open,
manometer open, and both open, respectively). All differences above are significant
(p < 0.0001).
Conclusions
In a normal lung, the volumes delivered by SIRs are significantly decreased with the
pop-off valve and manometer port open. Proper set-up of the SIR becomes even more
important when lung compliance is poor.
Keywords
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References
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Article info
Publication history
Published online: May 18, 2009
Accepted:
April 10,
2009
Received in revised form:
February 3,
2009
Received:
October 31,
2008
Identification
Copyright
© 2011 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
