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; Simone K. Dold; Marta Thio; Arjan tePas; Gerd Schmalisch; Charles Christoph Roehr

doi:10.1055/s-0033-1354562

American Journal of Perinatology, Table of Contents

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

Authors

Julia C. Hartung

¹Department of Neonatology, Charité University Medical Center, Berlin, Germany
Simone K. Dold

¹Department of Neonatology, Charité University Medical Center, Berlin, Germany
Marta Thio

²Department of Newborn Research, The Royal Women's Hospital, Melbourne, Australia
Arjan tePas

³Division of Neonatology, Department of Pediatrics, Leiden University Medical Center, Leiden, The Netherlands
Gerd Schmalisch

¹Department of Neonatology, Charité University Medical Center, Berlin, Germany

^* Gerd Schmalisch, PhD, and Charles Christoph Roehr, MD, PhD, share last authorship
Charles Christoph Roehr

¹Department of Neonatology, Charité University Medical Center, Berlin, Germany

²Department of Newborn Research, The Royal Women's Hospital, Melbourne, Australia

⁴The Ritchie Centre, Monash Institute of Medical Research, Monash University, Melbourne, Australia

^* Gerd Schmalisch, PhD, and Charles Christoph Roehr, MD, PhD, share last authorship

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

Full Text

References

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