The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians · 2016
Comparison of positive pressure ventilation devices in a newborn manikin.
Сравнительное исследованиеСтатьяНазвание и аннотация: Перевод в очереди
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Solevåg Anne Lee, Haemmerle Enrico, van Os Sylvia, Bach Katinka P, Cheung Po-Yin, Schmölzer Georg M
Аннотация
OBJECTIVE: To compare tidal volume (VT) delivery and ventilation rate between devices for positive pressure ventilation (PPV) during newborn resuscitation.
METHODS: Neonatal resuscitation program providers (n = 25) delivered PPV to a newborn manikin in a randomized order with: a self-inflating bag (SIB), a disposable T-piece, a non-disposable T-piece, a stand-alone infant resuscitation system T-piece and the volume-controlled prototype Next StepTM device (KM Medical). All T-pieces used a peak inflation pressure of 20cmH2O and a 5cmH2O positive end-expiratory pressure (PEEP). The SIB neither had a PEEP valve nor manometer. The Next StepTM had a 5cmH2O PEEP valve. The participants aimed to deliver a 5 mL/kg VT (rate 40-60 min-1) for 1 min with each device and each of three compliances (0.5, 1.0 and 2.0 mL/cmH2O). VT and ventilation rate were compared between devices and compliance levels (ANOVA) Results: All devices, except the Next StepTM delivered a 4-5 mL/kg VT at the low compliance, but three- to four-fold that of the target at the higher compliance levels. The Next StepTM delivered a VT close to target at all compliance levels. The ventilation rate was within 40-60 min-1 with all devices and compliance levels.
CONCLUSIONS: Routinely used ventilation devices for newborn resuscitation can triple intended VT and requires further investigation.
METHODS: Neonatal resuscitation program providers (n = 25) delivered PPV to a newborn manikin in a randomized order with: a self-inflating bag (SIB), a disposable T-piece, a non-disposable T-piece, a stand-alone infant resuscitation system T-piece and the volume-controlled prototype Next StepTM device (KM Medical). All T-pieces used a peak inflation pressure of 20cmH2O and a 5cmH2O positive end-expiratory pressure (PEEP). The SIB neither had a PEEP valve nor manometer. The Next StepTM had a 5cmH2O PEEP valve. The participants aimed to deliver a 5 mL/kg VT (rate 40-60 min-1) for 1 min with each device and each of three compliances (0.5, 1.0 and 2.0 mL/cmH2O). VT and ventilation rate were compared between devices and compliance levels (ANOVA) Results: All devices, except the Next StepTM delivered a 4-5 mL/kg VT at the low compliance, but three- to four-fold that of the target at the higher compliance levels. The Next StepTM delivered a VT close to target at all compliance levels. The ventilation rate was within 40-60 min-1 with all devices and compliance levels.
CONCLUSIONS: Routinely used ventilation devices for newborn resuscitation can triple intended VT and requires further investigation.