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

OBJECTIVE: We evaluated the effect of oxygen (O2) flow rate on the corresponding delivered fraction of oxygen (FiO2) 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 O2 source equipped with a flowmeter (flow rates: 0-10 L/min). The FiO2 corresponding to each flow rate was measured at the inflow to the facial mask for 60 seconds. RESULTS: In total, 2520 FiO2 data points were collected. At every O2 flow rate, the FiO2 gradually increased from time 0 seconds to time 60 seconds, both at 25 cm H 2O and at 35 cm H2O. After 1 minute of PPV at 25 cm H 2O, the delivered FiO2 was 31.5% ± 2.1% and 43.1% ± 3.1% at O2 flow rates of 0.1 and 0.5 L/min, respectively. After 1 minute of PPV at 35 cm H2O, the delivered FiO2 was 29.4% ± 2.0% and 42.1% ± 4.6% at O2 flow rates of 0.1 and 0.5 L/min, respectively. At all O2 flow rates >5 L/min, the delivered FiO2 was >85% and >95%, after 1 minute of PPV at 25 and 35 cm H2O, respectively. CONCLUSIONS: Delivered FiO2 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 FiO2 when using a neonatal SIB. Copyright © 2013 by the American Academy of Pediatrics.