Reliability of Single-Use PEEP-Valves Attached to Self-Inflating Bags during Manual Ventilation of Neonates--An In Vitro Study.
International resuscitation guidelines suggest to use positive end-expiratory pressure (PEEP) during manual ventilation of neonates. Aim of our study was to test the reliability of self-inflating bags (SIB) with single-use PEEP valves regarding PEEP delivery and the effect of different peak inflatio...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2016-01-01
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| Series: | PLoS ONE |
| Online Access: | http://europepmc.org/articles/PMC4767411?pdf=render |
| _version_ | 1828486651376041984 |
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| author | Julia C Hartung Silke Wilitzki Marta Thio-Lluch Arjan B te Pas Gerd Schmalisch Charles C Roehr |
| author_facet | Julia C Hartung Silke Wilitzki Marta Thio-Lluch Arjan B te Pas Gerd Schmalisch Charles C Roehr |
| author_sort | Julia C Hartung |
| collection | DOAJ |
| description | International resuscitation guidelines suggest to use positive end-expiratory pressure (PEEP) during manual ventilation of neonates. Aim of our study was to test the reliability of self-inflating bags (SIB) with single-use PEEP valves regarding PEEP delivery and the effect of different peak inflation pressures (PIP) and ventilation rates (VR) on the delivered PEEP.Ten new single-use PEEP valves from 5 manufacturers were tested by ventilating an intubated 1 kg neonatal manikin containing a lung model with a SIB that was actuated by an electromechanical plunger device. Standard settings: PIP 20 cmH2O, VR 60/min, flow 8 L/min. PEEP settings of 5 and 10 cmH2O were studied. A second test was conducted with settings of PIP 40 cmH2O and VR 40/min. The delivered PEEP was measured by a respiratory function monitor (CO2SMO+).Valves from one manufacturer delivered no relevant PEEP and were excluded. The remaining valves showed a continuous decay of the delivered pressure during expiration. The median (25th and 75th percentile) delivered PEEP with standard settings was 3.4(2.7-3.8) cmH2O when set to 5 cmH2O and 6.1(4.9-7.1) cmH2O when set to 10 cmH2O. Increasing the PIP from 20 to 40 cmH2O led to a median (25th and 75th percentile) decrease in PEEP to 2.3(1.8-2.7) cmH2O and 4.3(3.2-4.8) cmH2O; changing VR from 60 to 40/min led to a PEEP decrease to 2.8(2.1-3.3) cmH2O and 5.0(3.5-6.2) cmH2O for both PEEP settings.Single-use PEEP valves do not reliably deliver the set PEEP. PIP and VR have an effect on the delivered PEEP. Operators should be aware of these limitations when manually ventilating neonates. |
| first_indexed | 2024-12-11T09:36:40Z |
| format | Article |
| id | doaj.art-c623a9598ff3476c95a99c35bcee8750 |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-12-11T09:36:40Z |
| publishDate | 2016-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-c623a9598ff3476c95a99c35bcee87502022-12-22T01:12:51ZengPublic Library of Science (PLoS)PLoS ONE1932-62032016-01-01112e015022410.1371/journal.pone.0150224Reliability of Single-Use PEEP-Valves Attached to Self-Inflating Bags during Manual Ventilation of Neonates--An In Vitro Study.Julia C HartungSilke WilitzkiMarta Thio-LluchArjan B te PasGerd SchmalischCharles C RoehrInternational resuscitation guidelines suggest to use positive end-expiratory pressure (PEEP) during manual ventilation of neonates. Aim of our study was to test the reliability of self-inflating bags (SIB) with single-use PEEP valves regarding PEEP delivery and the effect of different peak inflation pressures (PIP) and ventilation rates (VR) on the delivered PEEP.Ten new single-use PEEP valves from 5 manufacturers were tested by ventilating an intubated 1 kg neonatal manikin containing a lung model with a SIB that was actuated by an electromechanical plunger device. Standard settings: PIP 20 cmH2O, VR 60/min, flow 8 L/min. PEEP settings of 5 and 10 cmH2O were studied. A second test was conducted with settings of PIP 40 cmH2O and VR 40/min. The delivered PEEP was measured by a respiratory function monitor (CO2SMO+).Valves from one manufacturer delivered no relevant PEEP and were excluded. The remaining valves showed a continuous decay of the delivered pressure during expiration. The median (25th and 75th percentile) delivered PEEP with standard settings was 3.4(2.7-3.8) cmH2O when set to 5 cmH2O and 6.1(4.9-7.1) cmH2O when set to 10 cmH2O. Increasing the PIP from 20 to 40 cmH2O led to a median (25th and 75th percentile) decrease in PEEP to 2.3(1.8-2.7) cmH2O and 4.3(3.2-4.8) cmH2O; changing VR from 60 to 40/min led to a PEEP decrease to 2.8(2.1-3.3) cmH2O and 5.0(3.5-6.2) cmH2O for both PEEP settings.Single-use PEEP valves do not reliably deliver the set PEEP. PIP and VR have an effect on the delivered PEEP. Operators should be aware of these limitations when manually ventilating neonates.http://europepmc.org/articles/PMC4767411?pdf=render |
| spellingShingle | Julia C Hartung Silke Wilitzki Marta Thio-Lluch Arjan B te Pas Gerd Schmalisch Charles C Roehr Reliability of Single-Use PEEP-Valves Attached to Self-Inflating Bags during Manual Ventilation of Neonates--An In Vitro Study. PLoS ONE |
| title | Reliability of Single-Use PEEP-Valves Attached to Self-Inflating Bags during Manual Ventilation of Neonates--An In Vitro Study. |
| title_full | Reliability of Single-Use PEEP-Valves Attached to Self-Inflating Bags during Manual Ventilation of Neonates--An In Vitro Study. |
| title_fullStr | Reliability of Single-Use PEEP-Valves Attached to Self-Inflating Bags during Manual Ventilation of Neonates--An In Vitro Study. |
| title_full_unstemmed | Reliability of Single-Use PEEP-Valves Attached to Self-Inflating Bags during Manual Ventilation of Neonates--An In Vitro Study. |
| title_short | Reliability of Single-Use PEEP-Valves Attached to Self-Inflating Bags during Manual Ventilation of Neonates--An In Vitro Study. |
| title_sort | reliability of single use peep valves attached to self inflating bags during manual ventilation of neonates an in vitro study |
| url | http://europepmc.org/articles/PMC4767411?pdf=render |
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