Comparison of positive pressure ventilation devices in a newborn manikin

摘要

Objective: To compare tidal volume (V-T) 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 Step(TM) device (KM Medical). All T-pieces used a peak inflation pressure of 20cmH(2)O and a 5cmH(2)O positive end-expiratory pressure (PEEP). The SIB neither had a PEEP valve nor manometer. The Next Step(TM) had a 5cmH(2)O PEEP valve. The participants aimed to deliver a 5mL/kg V-T (rate 40-60min(-1)) for 1min with each device and each of three compliances (0.5, 1.0 and 2.0mL/cmH(2)O). V-T and ventilation rate were compared between devices and compliance levels (ANOVA)Results: All devices, except the Next Step(TM) delivered a 4-5mL/kg V-T at the low compliance, but three- to four-fold that of the target at the higher compliance levels. The Next Step(TM) delivered a V-T close to target at all compliance levels. The ventilation rate was within 40-60min(-1) with all devices and compliance levels.Conclusions: Routinely used ventilation devices for newborn resuscitation can triple intended V-T and requires further investigation.