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Am J Perinatol 2014; 31(06): 505-512
DOI: 10.1055/s-0033-1354562
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Time to Adjust to Changes in Ventilation Settings Varies Significantly between Different T-Piece Resuscitators, Self-Inflating Bags, and Manometer Equipped Self-Inflating Bags

Julia C. Hartung
1   Department of Neonatology, Charité University Medical Center, Berlin, Germany
,
Simone K. Dold
1   Department of Neonatology, Charité University Medical Center, Berlin, Germany
,
Marta Thio
2   Department of Newborn Research, The Royal Women's Hospital, Melbourne, Australia
,
Arjan tePas
3   Division of Neonatology, Department of Pediatrics, Leiden University Medical Center, Leiden, The Netherlands
,
Gerd Schmalisch
1   Department of Neonatology, Charité University Medical Center, Berlin, Germany
*   Gerd Schmalisch, PhD, and Charles Christoph Roehr, MD, PhD, share last authorship
,
Charles Christoph Roehr
1   Department of Neonatology, Charité University Medical Center, Berlin, Germany
2   Department of Newborn Research, The Royal Women's Hospital, Melbourne, Australia
4   The Ritchie Centre, Monash Institute of Medical Research, Monash University, Melbourne, Australia
*   Gerd Schmalisch, PhD, and Charles Christoph Roehr, MD, PhD, share last authorship
› Author Affiliations
Further Information

Publication History

18 January 2013

19 July 2013

Publication Date:
02 September 2013 (online)

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Abstract

Objective Resuscitation guidelines give no preference over use of self-inflating bags (SIBs) or T-piece resuscitators (TPR) for manual neonatal ventilation. We speculated that devices would differ significantly regarding time required to adjust to changed ventilation settings.

Study Design This was a laboratory study. Time to adjust from baseline peak inflation pressure (PIP) (20 cmH2O) to target PIP (25 and 40 cmH2O), ability to adhere to predefined ventilation settings (PIP, PEEP, and inflation rate [IR]), and the variability within and between operators were assessed for a SIB without manometer, SIB with manometer (SIBM), and two TPRs.

Results Adjustment time was significantly longer with TPRs, compared with SIB and SIBM. The SIBM and TPRs were < 5% (median) off target PIP, and the SIB was 14% off target PIP. Significant variability between operators (interquartile range [IQR]: 71%) was seen with SIBs.

Conclusion PIP adjustment takes longer with TPRs, compared with SIB/SIBM. TPRs and SIBM allow satisfactory adherence to ventilation parameters. SIBs should only be used with manometer attached.

Keywords

neonate - resuscitation - ventilation - airway - PIP - self-inflating bag - T-piece resuscitator
 

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