A Novel Prototype Neonatal Resuscitator that Controls Tidal Volume and Ventilation Rate. A Comparative Study of Mask Ventilation in a Newborn Manikin

Frontiers in Pediatrics

Katinka P Bach²  Enrico Haemmerle³  Sylvia van Os⁴  Georg M Schmölzer⁵  Po-Yin Cheung⁵  Anne Lee Solevåg⁵ 

[1] Akershus University Hospital;Auckland City Hospital;Auckland University of Technology;Royal Alexandra Hospital;University of Alberta;

关键词: Bronchopulmonary Dysplasia;    Critical Care;    Resuscitation;    Tidal Volume;    Ventilation;    Newborn;   

DOI  :  10.3389/fped.2016.00129

来源: DOAJ

【 摘 要 】

The objective of this randomized controlled manikin trial was to examine tidal volume (VT) delivery and ventilation rate during mask positive pressure ventilation (PPV) with five different devices, including a volume-controlled prototype Next StepTM device for neonatal resuscitation. We hypothesized that VT and rate would be closest to target with the Next StepTM. Twenty-five Neonatal Resuscitation Program (NRP) providers provided mask PPV to a newborn manikin (simulated weight 1kg) in a randomized order with: a self-inflating bag (SIB), a disposable T-piece, a non-disposable T-piece, a stand-alone resuscitation system T-piece, and the Next StepTM. All T-pieces used a peak inflation pressure of 20cmH2O and a positive end-expiratory pressure of 5cmH2O. The participants were instructed to deliver a 5mL/kg VT (rate 40-60min-1) for 1min with each device and each of three test lungs with increasing compliance of 0.5, 1.0 and 2.0mL/cmH2O.VT and ventilation rate were compared between devices and compliance levels (linear mixed model). All devices, except the Next StepTM delivered a too high VT, up to six-fold the target at the 2.0mL/cmH2O compliance. The Next StepTMVT was 26% lower than the target in the low compliance. The ventilation rate was within target with the Next StepTM and SIB, and slightly lower with the T-pieces. In conclusion, routinely used newborn resuscitators over delivered VT, whereas the Next StepTM under delivered in the low compliant test lung. The SIB had higher VT and rate than the T-pieces. More research is needed on volume-controlled delivery room ventilation.

【 授权许可】

Unknown