Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
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SHR Neuro Krebs Kardio Lipid Stoffw Microb
Schilleman, K; Schmölzer, GM; Kamlin, OC; Morley, CJ; Te Pas, AB; Davis, PG.
Changing gas flow during neonatal resuscitation: A manikin study.
Resuscitation. 2011; 82(7):920-924
Doi: 10.1016/j.resuscitation.2011.02.029
Web of Science
PubMed
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FullText_MUG
- Co-Autor*innen der Med Uni Graz
- Schmölzer Georg
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- Abstract:
- Introduction: When using a T-piece device, resuscitators may try to improve airway pressures by increasing gas flow instead of correcting face mask position. Aim: To measure the effects of changing gas flow during positive pressure ventilation (PPV) on peak inspiratory pressure (PIP), positive end expiratory pressure (PEEP), expiratory tidal volume (V(Te)) and mask leak. Methods: Using a Neopuff T-piece device, 20 neonatal staff members delivered PPV to a modified, leak-free manikin. Resuscitation parameters were recorded. Study A: PPV for 4 min at PIP 30 cm H(2)O and PEEP 5 cm H(2)O. Each minute gas flow was increased (5, 8, 10, and 15 L/min). PIP and PEEP settings were unchanged. Study B: same pressure settings; PPV for 1 min with 5, 8, 10, and 15 L/min in a random order, at a rate of similar to 60/min. The pressures were adjusted to maintain the same PIP and PEEP after each flow change. Results: Study A: As gas flow increased (5, 8, 10 and 15 L/min) the median PEEP increased from 4.7 to 26.4 cm H(2)O (p < 0.002). Median V(Te) decreased from 10.0 to 0.8mL (p < 0.001). PIP increased slightly from 30 cm H(2)O to 36 cm H(2)O at 15 L/min (p < 0.005). Mask leak increased from 14% to 98% (p < 0.001) because mask pressure increased. Study B: when PIP and PEEP were maintained there were no significant differences in V(Te) (p = 0.42) or mask leak (p = 0.51) with changing gas flow. Conclusion: During PPV increasing gas flow dramatically increased PEEP and mask leak and in consequence reduced V(Te). Gas flow should rarely be changed during T-piece resuscitation. (C) 2011 Elsevier Ireland Ltd. All rights reserved.
- Find related publications in this database (using NLM MeSH Indexing)
- Cardiopulmonary Resuscitation - education
- Education, Medical - methods
- Equipment Design -
- Gases -
- Heart Arrest - physiopathology
- Humans -
- Infant, Newborn -
- Inspiratory Capacity - physiology
- Manikins -
- Positive-Pressure Respiration - methods
- Tidal Volume - physiology
- Find related publications in this database (Keywords)
- Neonatal resuscitation
- Positive pressure ventilation
- T-Piece
- Gas flow
- Mask leak
- Tidal volume