| Changing gas flow during neonatal resuscitation: A manikin study. | |
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MedLine Citation:
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PMID: 21444142 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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INTRODUCTION: When using a T-piece device, resuscitators may try to improve airway pressures by increasing gas flow instead of correcting face mask position. AIM: To measure the effects of changing gas flow during positive pressure ventilation (PPV) on peak inspiratory pressure (PIP), positive end expiratory pressure (PEEP), expiratory tidal volume (V(Te)) and mask leak. METHODS: Using a Neopuff T-piece device, 20 neonatal staff members delivered PPV to a modified, leak-free manikin. Resuscitation parameters were recorded. Study A: PPV for 4min at PIP 30cm H(2)O and PEEP 5cm H(2)O. Each minute gas flow was increased (5, 8, 10, and 15L/min). PIP and PEEP settings were unchanged. Study B: same pressure settings; PPV for 1min with 5, 8, 10, and 15L/min in a random order, at a rate of ∼60/min. The pressures were adjusted to maintain the same PIP and PEEP after each flow change. RESULTS: Study A: As gas flow increased (5, 8, 10 and 15L/min) the median PEEP increased from 4.7 to 26.4cm H(2)O (p<0.002). Median V(Te) decreased from 10.0 to 0.8mL (p<0.001). PIP increased slightly from 30cm H(2)O to 36cm H(2)O at 15L/min (p<0.005). Mask leak increased from 14% to 98% (p<0.001) because mask pressure increased. Study B: when PIP and PEEP were maintained there were no significant differences in V(Te) (p=0.42) or mask leak (p=0.51) with changing gas flow. CONCLUSION: During PPV increasing gas flow dramatically increased PEEP and mask leak and in consequence reduced V(Te). Gas flow should rarely be changed during T-piece resuscitation. |
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Authors:
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Kim Schilleman; Georg M Schmölzer; Omar C O F Kamlin; Colin J Morley; Arjan B Te Pas; Peter G Davis |
Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-3-26 |
Journal Detail:
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Title: Resuscitation Volume: - ISSN: 1873-1570 ISO Abbreviation: - Publication Date: 2011 Mar |
Date Detail:
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Created Date: 2011-3-29 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0332173 Medline TA: Resuscitation Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
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Copyright © 2011 Elsevier Ireland Ltd. All rights reserved. |
Affiliation:
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Department of Newborn Research, Royal Women's Hospital, Melbourne, Australia; Department of Pediatrics, Division of Neonatology, Leiden University Medical Center, Leiden, The Netherlands. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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