• Daniele Trevisanuto, Valentina Dal Cengio, Nicoletta Doglioni, Francesco Cavallin, Vincenzo Zanardo, Matteo Parotto, and Gary Weiner.
• Department of Woman and Child Health, Medical School, University of Padua, Azienda Ospedaliera Padova, Via Giustiniani, 3, 35128 Padua, Italy. trevo@pediatria.unipd.it
• Pediatrics. 2013 Apr 1; 131 (4): e1144-9.

ObjectiveWe 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).MethodsFifteen 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.ResultsIn 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 H₂O and at 35 cm H₂O. After 1 minute of PPV at 25 cm H₂O, 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.ConclusionsDelivered 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.

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