AUTHOR=Solevåg Anne Lee , Haemmerle Enrico , van Os Sylvia , Bach Katinka P. , Cheung Po-Yin , Schmölzer Georg M. 

TITLE=A Novel Prototype Neonatal Resuscitator That Controls Tidal Volume and Ventilation Rate: A Comparative Study of Mask Ventilation in a Newborn Manikin

JOURNAL=Frontiers in Pediatrics

VOLUME=4

YEAR=2016

URL=https://www.frontiersin.org/journals/pediatrics/articles/10.3389/fped.2016.00129

DOI=10.3389/fped.2016.00129

ISSN=2296-2360

ABSTRACT=<p>The objective of this randomized controlled manikin trial was to examine tidal volume (V<sub>T</sub>) delivery and ventilation rate during mask positive pressure ventilation (PPV) with five different devices, including a volume-controlled prototype Next Step™ device for neonatal resuscitation. We hypothesized that V<sub>T</sub> and rate would be closest to target with the Next Step™. Twenty-five Neonatal Resuscitation Program providers provided mask PPV to a newborn manikin (simulated weight 1 kg) in a randomized order with a self-inflating bag (SIB), a disposable T-piece, a non-disposable T-piece, a stand-alone resuscitation system T-piece, and the Next Step™. All T-pieces used a peak inflation pressure of 20 cmH<sub>2</sub>O and a positive end-expiratory pressure of 5 cmH<sub>2</sub>O. The participants were instructed to deliver a 5 mL/kg V<sub>T</sub> (rate 40–60/min) for 1 min with each device and each of three test lungs with increasing compliance of 0.5, 1.0, and 2.0 mL/cmH<sub>2</sub>O. V<sub>T</sub> and ventilation rate were compared between devices and compliance levels (linear mixed model). All devices, except the Next Step™ delivered a too high V<sub>T</sub>, up to sixfold the target at the 2.0-mL/cmH<sub>2</sub>O compliance. The Next Step™ V<sub>T</sub> was 26% lower than the target in the low compliance. The ventilation rate was within target with the Next Step™ and SIB, and slightly lower with the T-pieces. In conclusion, routinely used newborn resuscitators over delivered V<sub>T</sub>, whereas the Next Step™ under delivered in the low compliant test lung. The SIB had higher V<sub>T</sub> and rate than the T-pieces. More research is needed on volume-controlled delivery room ventilation.</p>