Discrepancy in applied tidal volumes between t-piece and lung level during delivery room stabilization - a case report.

We present data of a preterm infant at 28 4/7 weeks gestation with inadequate response to non-invasive ventilation after birth who was intubated five minutes after delivery. During non-invasive stabilization, we noted a discrepancy between the displayed tidal volumes on the respiratory function monitor (RFM) and the real-time electrical impedance tomography (EIT) measurements. While expiratory tidal volumes on the RFM were in the recommended target of 4-6 mL/kg, EIT showed only minimal tidal volumes (corresponding to approximately 1-3 mL/kg), which was more consistent with the clinical impression of the neonate. After intubation, tidal volumes shown on RFM and EIT were similar, suggesting that RFM may be unreliable during non-invasive ventilation, possibly due to the large compliance of the nasopharyngeal space. EIT may be a helpful additional clinical tool in selective cases in the delivery room.