Use of self-inflating bags for neonatal resuscitation

Resuscitation. 2005 Oct;67(1):109-12. doi: 10.1016/j.resuscitation.2005.05.004.


Background: Lung inflation is the most important, and most difficult step in newborn resuscitation. A wide variety of devices are used to achieve lung inflation, but there are relatively few data to guide clinicians in their choice of device.

Methods: We tested the ability of instructors and trained candidates on a newborn life support course to deliver initial inflation breaths to a test lung, using a pressure limited blow-off valve, a 240-ml self-inflating bag and a 500-ml self-inflating bag in sequence.

Results: Use of a 240-ml self-inflating bag was associated with shorter initial inflations of 1.8 s mean (95% CI 1.60-1.99 s), compared with 2.42 s (2.24-2.61 s), 2.40 s (2.08-2.71 s) for 500-ml self-inflating bags and "Tom Thumb" T piece, respectively. Delivery of breaths within a target pressure range of 30+/-5 cm H2O was significantly better using a T piece than either self-inflating bag (proportion within target range 0.05 (95% CI 0-0.11), 0.17 (95% CI 0.12-0.23), 0.89 (95% CI 0.83-0.94) for 240-ml and 500-ml self-inflating bags and "Tom Thumb" T piece, respectively. Excessive pressure delivery with both sizes of self-inflating bag was frequent.

Conclusions: These data do not support use of 240-ml or 500-ml self-inflating bags for resuscitation of newborn term infants. A variable pressure T piece blow-off system may be the easiest device to use for newborn resuscitation and the most reliable at delivering desired pressures for set times.

Publication types

  • Comparative Study

MeSH terms

  • Age Factors
  • Cardiopulmonary Resuscitation / education*
  • Clinical Competence*
  • Education, Professional
  • Humans
  • Infant, Newborn
  • Insufflation / instrumentation*
  • Oxygen / therapeutic use
  • Patient Simulation
  • Respiration, Artificial / instrumentation*
  • Respiration, Artificial / methods
  • Risk Assessment
  • Sensitivity and Specificity


  • Oxygen