Equipment and Operator Training Denote Manual Ventilation Performance in Neonatal Resuscitation

ABSTRACT

High peak inspiratory pressure (PIP) and tidal volume (V_T) from manual ventilation are hazardous to the neonatal lung. We investigated the influence of operator training on the extent of applied PIP and V_T between two manual ventilation devices. We performed a prospective, crossover study of 84 medical professionals using a neonatal mannequin. Participants were classified into four groups, according to experience in neonatal resuscitation and previous training in manual ventilation. Provision of PIP, V_T, and inspiratory time (Ti) were compared between groups and equipment used, either a self-inflating bag (SI-bag) or a T-piece resuscitator (Neopuff^®). Using SI-bags, operator training significantly affected provision of PIP (p < 0.001), V_T (p < 0.001), and Ti (p = 0.048). Using a T-piece device, PIP and V_T provision was independent of operator training (p = 0.55 and p = 0.66, respectively). Twenty-five participants (30%) had previous experience with T-piece devices; this correlated significantly with lower PIP and lower V_T provision (p > 0.001 for PIP and V_T). Operator training level and device-specific experience had a significant impact on PIP and V_T provision when using SI-bags for manual ventilation. For operators with no specific training in manual ventilation, use of T-piece devices is advised to control for excessive PIP and V_T application.

KEYWORDS

Resuscitation - training - T-piece resuscitator - self-inflating bag - neonate

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0 Both authors contributed equally to this paper