• Mark B Tracy, Dharmesh Shah, Murray Hinder, Jan Klimek, James Marceau, and Audrey Wright.
• Neonatal Intensive Care Unit, Westmead Hospital, Sydney, Australia; Sydney Medical School, University of Sydney, Sydney, Australia.
• Acta Paediatr. 2014 May 1;103(5):e182-7.

AimTo determine changes in respiratory mechanics when chest compressions are added to mask ventilation, as recommended by the International Liaison Committee on Resuscitation (ILCOR) guidelines for newborn infants.MethodsUsing a Laerdal Advanced Life Support leak-free baby manikin and a 240-mL self-inflating bag, 58 neonatal staff members were randomly paired to provide mask ventilation, followed by mask ventilation with chest compressions with a 1:3 ratio, for two minutes each. A Florian respiratory function monitor was used to measure respiratory mechanics, including mask leak.ResultsThe addition of chest compressions to mask ventilation led to a significant reduction in inflation rate, from 63.9 to 32.9 breaths per minute (p < 0.0001), mean airway pressure reduced from 7.6 to 4.9 cm H2 O (p < 0.001), minute ventilation reduced from 770 to 451 mL/kg/min (p < 0.0001), and there was a significant increase in paired mask leak of 6.8% (p < 0.0001).ConclusionAdding chest compressions to mask ventilation, in accordance with the ILCOR guidelines, in a manikin model is associated with a significant reduction in delivered ventilation and increase in mask leak. If similar findings occur in human infants needing an escalation in resuscitation, there is a potential risk of either delay in recovery or inadequate response to resuscitation.©2014 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

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