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摘要
The objective of this randomized controlled manikin trial was to examine tidal volume (V-T) delivery and ventilation rate during mask positive pressure ventilation (PPV) with five different devices, including a volume-controlled prototype Next Step (TM) device for neonatal resuscitation. We hypothesized that V-T and rate would be closest to target with the Next Step (TM). Twenty-five Neonatal Resuscitation Program providers provided mask PPV to a newborn manikin (simulated weight 1 kg) 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 Step (TM). All T-pieces used a peak inflation pressure of 20 cmH(2)O and a positive end-expiratory pressure of 5 cmH(2)O. The participants were instructed to deliver a 5 mL/kg V-T (rate 40-60/min) for 1 min with each device and each of three test lungs with increasing compliance of 0.5, 1.0, and 2.0 mL/cmH(2)O. V-T and ventilation rate were compared between devices and compliance levels (linear mixed model). All devices, except the Next Step (TM) delivered a too high V-T, up to sixfold the target at the 2.0-mL/cmH(2)O compliance. The Next Step (TM) V-T was 26% lower than the target in the low compliance. The ventilation rate was within target with the Next Step (TM) and SIB, and slightly lower with the T-pieces. In conclusion, routinely used newborn resuscitators over delivered V-T, whereas the Next Step (TM) under delivered in the low compliant test lung. The SIB had higher V-T and rate than the T-pieces. More research is needed on volume-controlled delivery room ventilation.
- 出版日期2016-11-28
