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

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...

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Main Authors: Anne Lee Solevåg, Enrico Haemmerle, Sylvia van Os, Katinka P Bach, Po-Yin Cheung, Georg M Schmölzer
Format: Article
Language:English
Published: Frontiers Media S.A. 2016-11-01
Series:Frontiers in Pediatrics
Subjects:
Online Access:http://journal.frontiersin.org/Journal/10.3389/fped.2016.00129/full
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author Anne Lee Solevåg
Anne Lee Solevåg
Anne Lee Solevåg
Enrico Haemmerle
Sylvia van Os
Katinka P Bach
Po-Yin Cheung
Po-Yin Cheung
Georg M Schmölzer
Georg M Schmölzer
author_facet Anne Lee Solevåg
Anne Lee Solevåg
Anne Lee Solevåg
Enrico Haemmerle
Sylvia van Os
Katinka P Bach
Po-Yin Cheung
Po-Yin Cheung
Georg M Schmölzer
Georg M Schmölzer
author_sort Anne Lee Solevåg
collection DOAJ
description 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 StepTM VT 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.
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spelling doaj.art-db2b57282c234de0ac64ec4eb94ea3012022-12-21T22:27:55ZengFrontiers Media S.A.Frontiers in Pediatrics2296-23602016-11-01410.3389/fped.2016.00129226151A Novel Prototype Neonatal Resuscitator that Controls Tidal Volume and Ventilation Rate. A Comparative Study of Mask Ventilation in a Newborn ManikinAnne Lee Solevåg0Anne Lee Solevåg1Anne Lee Solevåg2Enrico Haemmerle3Sylvia van Os4Katinka P Bach5Po-Yin Cheung6Po-Yin Cheung7Georg M Schmölzer8Georg M Schmölzer9Akershus University HospitalRoyal Alexandra HospitalUniversity of AlbertaAuckland University of TechnologyRoyal Alexandra HospitalAuckland City HospitalRoyal Alexandra HospitalUniversity of AlbertaRoyal Alexandra HospitalUniversity of AlbertaThe 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 StepTM VT 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.http://journal.frontiersin.org/Journal/10.3389/fped.2016.00129/fullBronchopulmonary DysplasiaCritical CareResuscitationTidal VolumeVentilationNewborn
spellingShingle Anne Lee Solevåg
Anne Lee Solevåg
Anne Lee Solevåg
Enrico Haemmerle
Sylvia van Os
Katinka P Bach
Po-Yin Cheung
Po-Yin Cheung
Georg M Schmölzer
Georg M Schmölzer
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
Bronchopulmonary Dysplasia
Critical Care
Resuscitation
Tidal Volume
Ventilation
Newborn
title A Novel Prototype Neonatal Resuscitator that Controls Tidal Volume and Ventilation Rate. A Comparative Study of Mask Ventilation in a Newborn Manikin
title_full A Novel Prototype Neonatal Resuscitator that Controls Tidal Volume and Ventilation Rate. A Comparative Study of Mask Ventilation in a Newborn Manikin
title_fullStr A Novel Prototype Neonatal Resuscitator that Controls Tidal Volume and Ventilation Rate. A Comparative Study of Mask Ventilation in a Newborn Manikin
title_full_unstemmed A Novel Prototype Neonatal Resuscitator that Controls Tidal Volume and Ventilation Rate. A Comparative Study of Mask Ventilation in a Newborn Manikin
title_short A Novel Prototype Neonatal Resuscitator that Controls Tidal Volume and Ventilation Rate. A Comparative Study of Mask Ventilation in a Newborn Manikin
title_sort novel prototype neonatal resuscitator that controls tidal volume and ventilation rate a comparative study of mask ventilation in a newborn manikin
topic Bronchopulmonary Dysplasia
Critical Care
Resuscitation
Tidal Volume
Ventilation
Newborn
url http://journal.frontiersin.org/Journal/10.3389/fped.2016.00129/full
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