Comparison of positive pressure ventilation devices in a newborn manikin

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 min1) 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 min1 with all devices and compliance levels.

Conclusions: Routinely used ventilation devices for newborn resuscitation can triple intended VT and requires further investigation.

To access the article abstract click here.

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