Newborn manikin study shows that physicians often fail to detect correct lung compliance when using a self-inflating bag

Acta Paediatr. 2016 Feb;105(2):172-7. doi: 10.1111/apa.13114. Epub 2015 Aug 4.


Aim: Recognising changes in lung compliance can help clinicians to adjust initial inflations during resuscitation at birth. We examined whether physicians sensed low and normal compliance with a self-inflating bag before and after an educational intervention that used a manikin connected to a newborn lung simulator.

Methods: We asked 43 physicians with neonatal duties to perform two low compliance ventilation attempts and two normal-compliance ventilation attempts in a randomised order at baseline and after the educational intervention, with 34 taking part in a retest three months later.

Results: The physicians correctly recognised low and normal compliance in 71% and 66% of the ventilations at baseline, 80% and 66% of the ventilations after the intervention and 74% and 81% at retest. Correct recognition of normal compliance improved from baseline to retest (p = 0.04). Ventilations in low- vs normal-compliance settings resulted in lower tidal volumes (4.4 vs 23.0 mL, p < 0.001), lower ventilation rates (42 vs 51, p < 0.001) and higher peak inflating pressure (35.2 vs 31.4 cmH2 O, p < 0.001).

Conclusion: Around one in four physicians failed to recognise correct compliance levels when using a self-inflating bag and showed limited improvement after an educational intervention. Ventilations in a low-compliance setting resulted in suboptimal ventilation.

Keywords: Compliance; Lung; Manikin; Newborn; Self-inflating bag.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Female
  • Humans
  • Infant, Newborn
  • Lung Compliance / physiology*
  • Male
  • Manikins
  • Neonatology / standards
  • Respiratory Function Tests / instrumentation