Endotracheal resuscitation of neonates using a rebreathing bag. 1991

C J Upton, and A D Milner
Department of Neonatal Medicine and Surgery, City Hospital, Nottingham.

Thirty asphyxiated neonates were resuscitated endotracheally with an anaesthetic rebreathing bag. The system was not limited either by pressure or by volume and chest movement was used as the criterion for adequate inflation. Inflation pressure and flow were recorded during resuscitation, and flow was integrated to obtain volume. Median mean pressure over the first 10 inflations was 40 cm H2O and this dropped during later resuscitation to 29 cm H2O. The volume delivered did not change significantly, so volume divided by pressure increased from a median of 0.18 to 0.35 ml/kg/cm H2O. Fourteen infants formed part of their functional residual capacity with artificial ventilation and five with spontaneous breaths. Eleven infants showed no evidence of functional residual capacity formation. In the 22 preterm infants there was a strong association between absence of functional residual capacity formation and later hyaline membrane disease that required ventilation. We suggest that pressures of more than than 30 cm H2O may be helpful during initial resuscitation and that there should be further study of devices using positive end expiratory pressure for resuscitation of preterm infants.

UI MeSH Term Description Entries
D007231 Infant, Newborn An infant during the first 28 days after birth. Neonate,Newborns,Infants, Newborn,Neonates,Newborn,Newborn Infant,Newborn Infants
D007442 Intubation, Intratracheal A procedure involving placement of a tube into the trachea through the mouth or nose in order to provide a patient with oxygen and anesthesia. Intubation, Endotracheal,Endotracheal Intubation,Endotracheal Intubations,Intratracheal Intubation,Intratracheal Intubations,Intubations, Endotracheal,Intubations, Intratracheal
D008168 Lung Either of the pair of organs occupying the cavity of the thorax that effect the aeration of the blood. Lungs
D012151 Resuscitation The restoration to life or consciousness of one apparently dead. (Dorland, 27th ed) Resuscitations
D005652 Functional Residual Capacity The volume of air remaining in the LUNGS at the end of a normal, quiet expiration. It is the sum of the RESIDUAL VOLUME and the EXPIRATORY RESERVE VOLUME. Common abbreviation is FRC. Capacities, Functional Residual,Capacity, Functional Residual,Functional Residual Capacities,Residual Capacities, Functional,Residual Capacity, Functional
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D006819 Hyaline Membrane Disease A respiratory distress syndrome in newborn infants, usually premature infants with insufficient PULMONARY SURFACTANTS. The disease is characterized by the formation of a HYALINE-like membrane lining the terminal respiratory airspaces (PULMONARY ALVEOLI) and subsequent collapse of the lung (PULMONARY ATELECTASIS). Disease, Hyaline Membrane,Diseases, Hyaline Membrane,Hyaline Membrane Diseases
D000764 Anesthesia, Closed-Circuit Inhalation anesthesia where the gases exhaled by the patient are rebreathed as some carbon dioxide is simultaneously removed and anesthetic gas and oxygen are added so that no anesthetic escapes into the room. Closed-circuit anesthesia is used especially with explosive anesthetics to prevent fires where electrical sparking from instruments is possible. Anesthesia, Rebreathing,Closed-Circuit Anesthesia,Anesthesia, Closed Circuit,Anesthesias, Closed-Circuit,Anesthesias, Rebreathing,Closed Circuit Anesthesia,Closed-Circuit Anesthesias,Rebreathing Anesthesia,Rebreathing Anesthesias
D001238 Asphyxia Neonatorum Respiratory failure in the newborn. (Dorland, 27th ed)

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