| Variability in the Assessment of 'Adequate' Chest Excursion during Simulated Neonatal Resuscitation. | |
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MedLine Citation:
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PMID: 21311200 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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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. |
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Authors:
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M Brugada; K Schilleman; R S Witlox; F J Walther; M Vento; A B Te Pas |
Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-2-09 |
Journal Detail:
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Title: Neonatology Volume: 100 ISSN: 1661-7819 ISO Abbreviation: - Publication Date: 2011 Feb |
Date Detail:
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Created Date: 2011-2-11 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101286577 Medline TA: Neonatology Country: - |
Other Details:
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Languages: ENG Pagination: 99-104 Citation Subset: - |
Copyright Information:
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Copyright © 2011 S. Karger AG, Basel. |
Affiliation:
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Neonatal Research Unit and Institute for Health Research, University Hospital La Fe, Valencia, Spain. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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