Document Detail

Variability in the Assessment of 'Adequate' Chest Excursion during Simulated Neonatal Resuscitation.
MedLine Citation:
PMID:  21311200     Owner:  NLM     Status:  Publisher    
Background: International neonatal resuscitation guidelines recommend assessing chest excursion when the heart rate is not improving. However, the accuracy in assessing 'adequate' chest excursion lacks objectivity. Aim: It was the aim of this study to test the accuracy in the assessment of 'adequate' chest excursion by measuring intra- and inter-observer variability of participants during simulated neonatal resuscitation. Methods: Thirty-seven staff members (8 neonatologists, 8 registrars, 21 nurses) of the Neonatal Intensive Care Unit, Leiden University Medical Center, Leiden, The Netherlands, ventilated 2 different intubated, leak-free manikins at 2 attempts, each with a different compliance. Blinded to the manometer, participants could change the peak inflation pressure until chest movement was adequate according to their perception. Inflating pressures were recorded. Results: According to the participants, a median (interquartile range) pressure of 18 cm H(2)O (16-22) at the first and 18 cm H(2)O (16-25) at the second attempt were needed to reach adequate chest excursion in the Laerdal manikin. The HAL manikin needed 26 cm H(2)O (19-31) and 24 cm H(2)O (22-33), respectively. The inter-observer coefficient of variance was 30% with the Laerdal manikin at both attempts, and 35 and 40% with the HAL manikin, respectively. The intra-observer coefficient of variance was 15% (8-23) with the Laerdal and 13% (9-20) with the HAL manikin. In both manikins and attempts, no significant differences in pressures and variances of pressures between the 3 groups were found. Conclusion: 'Adequate' chest excursion is a subjective parameter for guidance of appropriate ventilation during neonatal resuscitation.
M Brugada; K Schilleman; R S Witlox; F J Walther; M Vento; A B Te Pas
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-2-09
Journal Detail:
Title:  Neonatology     Volume:  100     ISSN:  1661-7819     ISO Abbreviation:  -     Publication Date:  2011 Feb 
Date Detail:
Created Date:  2011-2-11     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101286577     Medline TA:  Neonatology     Country:  -    
Other Details:
Languages:  ENG     Pagination:  99-104     Citation Subset:  -    
Copyright Information:
Copyright © 2011 S. Karger AG, Basel.
Neonatal Research Unit and Institute for Health Research, University Hospital La Fe, Valencia, Spain.
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