Document Detail


Reliability of two common PEEP-generating devices used in neonatal resuscitation.
MedLine Citation:
PMID:  19731194     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Approximately 15% of neonates require respiratory support at birth, the demand of which increases with decreasing gestational age. Positive end-expiratory pressure (PEEP) stabilizes the airways and improves both pulmonary functional residual capacity and compliance. Self-inflating bags, which can be used with and without a PEEP-valve, are most commonly used for neonatal resuscitation, pressure limited T-piece resuscitators are becoming increasingly popular. The aim of the study was to investigate the reliability of PEEP provision of both systems. MATERIAL AND METHODS: An intubated, leak free mannequin (equivalent to 1 kg neonate, pulmonary compliance 0.2 ml*cmH (2)O (-1)) was used for testing both devices. Eleven PEEP-valves attached to a 240 ml self-inflating bag and 5 T-piece resuscitators were investigated. Provision of a PEEP of 5 cmH (2)O (gas flow of 8l/min) at manual ventilation at breaths 40/min was investigated. Data were recorded using a standard pneumotachograph. RESULTS: Only 1/11 PEEP-valves provided a PEEP of 5 cmH (2)O (mean (SD) 2.95 (1.82) cmH (2)O, CV 0.62%), in 5/11 (45%) PEEP was <3 cmH (2)O, in 2 of the PEEP-valves produced a PEEP below 0.3 cmH (2)O. All T-piece resuscitators provided a PEEP >5 cmH (2)O (mean 5.59 (0.32) cmH (2)O, CV 0.06%). Significant differences in individual performance per device (p<0.05) and between systems (p=0.007) were found. CONCLUSION: Self-inflating bags did not reliably provide the desired PEEP of 5 cmH (2)O, whereas T-piece resuscitators did reliably provide the set PEEP-level, with less variability. When using self-inflating bags with PEEP-valves, neonatologists should check the equipment regarding the reliability of PEEP provision.
Authors:
M Kelm; H Proquitt?; G Schmalisch; C C Roehr
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Klinische P?diatrie     Volume:  221     ISSN:  1439-3824     ISO Abbreviation:  Klin Padiatr     Publication Date:  2009 Dec 
Date Detail:
Created Date:  2009-12-16     Completed Date:  2010-03-15     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0326144     Medline TA:  Klin Padiatr     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  415-8     Citation Subset:  IM    
Copyright Information:
(c) Georg Thieme Verlag KG Stuttgart New York.
Affiliation:
Klinik f?r Neonatologie, Charit?, Universit?tsmedizin Berlin.
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MeSH Terms
Descriptor/Qualifier:
Cardiopulmonary Resuscitation / instrumentation*
Equipment Design
Equipment Failure Analysis
Humans
Infant, Newborn
Infant, Very Low Birth Weight*
Intubation, Intratracheal
Manikins
Positive-Pressure Respiration / instrumentation*

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