Time to Adjust to Changes in Ventilation Settings Varies Significantly between Different T-Piece Resuscitators, Self-Inflating Bags, and Manometer Equipped Self-Inflating Bags

Abstract

Objective Resuscitation guidelines give no preference over use of self-inflating bags (SIBs) or T-piece resuscitators (TPR) for manual neonatal ventilation. We speculated that devices would differ significantly regarding time required to adjust to changed ventilation settings.

Study Design This was a laboratory study. Time to adjust from baseline peak inflation pressure (PIP) (20 cmH₂O) to target PIP (25 and 40 cmH₂O), ability to adhere to predefined ventilation settings (PIP, PEEP, and inflation rate [IR]), and the variability within and between operators were assessed for a SIB without manometer, SIB with manometer (SIBM), and two TPRs.

Results Adjustment time was significantly longer with TPRs, compared with SIB and SIBM. The SIBM and TPRs were < 5% (median) off target PIP, and the SIB was 14% off target PIP. Significant variability between operators (interquartile range [IQR]: 71%) was seen with SIBs.

Conclusion PIP adjustment takes longer with TPRs, compared with SIB/SIBM. TPRs and SIBM allow satisfactory adherence to ventilation parameters. SIBs should only be used with manometer attached.

Keywords

neonate - resuscitation - ventilation - airway - PIP - self-inflating bag - T-piece resuscitator

• References

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