T-piece resuscitators: how do they compare?

Analysis of Variance Cardiopulmonary Resuscitation / methods Equipment Design Humans Infant Care / methods Infant, Newborn Positive-Pressure Respiration / instrumentation Tidal Volume
T-piece resuscitator inadvertent PEEP newborn resuscitation

Journal

Archives of disease in childhood. Fetal and neonatal edition
ISSN: 1468-2052
Titre abrégé: Arch Dis Child Fetal Neonatal Ed
Pays: England
ID NLM: 9501297

Informations de publication

Date de publication:
Mar 2019
Historique:
received: 23 01 2018
revised: 09 04 2018
accepted: 18 04 2018
pubmed: 8 5 2018
medline: 7 3 2019
entrez: 6 5 2018
Statut: ppublish

Résumé

The T-piece resuscitator (TPR) has seen increased use as a primary resuscitation device with newborns. Traditional TPR design uses a high resistance expiratory valve to produce positive end expiratory pressure (PEEP) or continuous positive airway pressure (CPAP) at resuscitation. A new TPR device that uses a dual flow ratio valve (fluidic flip) to produce PEEP/CPAP is now available (rPAP). We aimed to compare the measured ventilation performance of different TPR devices in a controlled bench test study. Single operator provided positive pressure ventilation to an incremental testlung compliance (Crs) model (0.5-5 mL/cmH 1864 inflations were analysed. Four of the five devices tested demonstrated inadvertent elevations in mean PEEP (5.5-10.3 cmH Results show important variation in delivered ventilation from set values due to inherent TPR device design characteristics with a range of lung compliances expected at birth. Device-generated inadvertent PEEP and overdelivery of PIP may be clinically deleterious for term and preterm newborns or infants with larger Crs during resuscitation.

Sections du résumé

BACKGROUND BACKGROUND
The T-piece resuscitator (TPR) has seen increased use as a primary resuscitation device with newborns. Traditional TPR design uses a high resistance expiratory valve to produce positive end expiratory pressure (PEEP) or continuous positive airway pressure (CPAP) at resuscitation. A new TPR device that uses a dual flow ratio valve (fluidic flip) to produce PEEP/CPAP is now available (rPAP). We aimed to compare the measured ventilation performance of different TPR devices in a controlled bench test study.
DESIGN/METHODS METHODS
Single operator provided positive pressure ventilation to an incremental testlung compliance (Crs) model (0.5-5 mL/cmH
RESULTS RESULTS
1864 inflations were analysed. Four of the five devices tested demonstrated inadvertent elevations in mean PEEP (5.5-10.3 cmH
CONCLUSIONS CONCLUSIONS
Results show important variation in delivered ventilation from set values due to inherent TPR device design characteristics with a range of lung compliances expected at birth. Device-generated inadvertent PEEP and overdelivery of PIP may be clinically deleterious for term and preterm newborns or infants with larger Crs during resuscitation.

Identifiants

DOI: 10.1136/archdischild-2018-314860 PMID: 29728414
pubmed: 29728414
pii: archdischild-2018-314860
doi: 10.1136/archdischild-2018-314860
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

F122-F127

Informations de copyright

© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2019. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Déclaration de conflit d'intérêts

Competing interests: TD is one of the inventors of the rPAP system and was not involved in collection of data or its analysis.

Auteurs

Murray Hinder (M)

Neonatal Intensive Care Unit, Westmead Hospital, Westmead, New South Wales, Australia.
Faculty of Engineering and Information Technologies, BMET Institute, Sydney University, Sydney, New South Wales, Australia.

Alistair McEwan (A)

Faculty of Engineering and Information Technologies, BMET Institute, Sydney University, Sydney, New South Wales, Australia.

Thomas Drevhammer (T)

Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.

Snorri Donaldson (S)

Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.

Mark Brian Tracy (MB)

Neonatal Intensive Care Unit, Westmead Hospital, Westmead, New South Wales, Australia.
Department of Paediatrics and Child Health, Sydney University, Westmead, New South Wales, Australia.

Articles similaires

[Redispensing of expensive oral anticancer medicines: a practical application].

Lisanne N van Merendonk, Kübra Akgöl, Bastiaan Nuijen
1.00
Humans Antineoplastic Agents Administration, Oral Drug Costs Counterfeit Drugs

Smoking Cessation and Incident Cardiovascular Disease.

Jun Hwan Cho, Seung Yong Shin, Hoseob Kim et al.
1.00
Humans Male Smoking Cessation Cardiovascular Diseases Female

Evaluation of Low-Value Services Across Major Medicare Advantage Insurers and Traditional Medicare.

Ciara Duggan, Adam L Beckman, Ishani Ganguli et al.
1.00
Humans United States Aged Cross-Sectional Studies Medicare Part C

Effectiveness of Virtual Yoga for Chronic Low Back Pain: A Randomized Clinical Trial.

Hallie Tankha, Devyn Gaskins, Amanda Shallcross et al.
1.00
Humans Yoga Low Back Pain Female Male

Classifications MeSH

questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Statistiques comme sujet › Analyse de variance › T-piece resuscitators: how do they compare?
questionsmedicales.fr › Thérapeutique › Traitement d'urgence › Réanimation › Réanimation cardiopulmonaire › T-piece resuscitators: how do they compare?
questionsmedicales.fr › Techniques d'investigation › Conception d'appareillage › T-piece resuscitators: how do they compare?
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › T-piece resuscitators: how do they compare?
questionsmedicales.fr › Établissements, main d'oeuvre et services de soins de santé › Services de santé › Soins de l'enfant › Soins du nourrisson › T-piece resuscitators: how do they compare?
questionsmedicales.fr › Personnes › Tranches d'âge › Nourrisson › Nouveau-né › T-piece resuscitators: how do they compare?
questionsmedicales.fr › Thérapeutique › Thérapie respiratoire › Ventilation artificielle › Ventilation à pression positive › T-piece resuscitators: how do they compare?
questionsmedicales.fr › Phénomènes physiologiques respiratoires et circulatoires › Phénomènes physiologiques respiratoires › Capacité pulmonaire totale › Capacité vitale › Capacité inspiratoire › Volume courant › T-piece resuscitators: how do they compare?