Comparison of positive pressure ventilation devices in a newborn manikin

To compare tidal volume (V_T) delivery and ventilation rate between devices for positive pressure ventilation (PPV) during newborn resuscitation.

Neonatal resuscitation program providers (n = 25) delivered PPV to a newborn manikin in a randomized order with: a self-inflating bag (SIB), a disposable T-piece, a non-disposable T-piece, a stand-alone infant resuscitation system T-piece and the volume-controlled prototype Next Step^TM device (KM Medical). All T-pieces used a peak inflation pressure of 20cmH₂O and a 5cmH₂O positive end-expiratory pressure (PEEP). The SIB neither had a PEEP valve nor manometer. The Next Step^TM had a 5cmH₂O PEEP valve. The participants aimed to deliver a 5 mL/kg V_T (rate 40-60 min^-1) for 1 min with each device and each of three compliances (0.5, 1.0 and 2.0 mL/cmH₂O). V_T and ventilation rate were compared between devices and compliance levels (ANOVA) Results: All devices, except the Next Step^TM delivered a 4-5 mL/kg V_T at the low compliance, but three- to four-fold that of the target at the higher compliance levels. The Next Step^TM delivered a V_T close to target at all compliance levels. The ventilation rate was within 40-60 min^-1 with all devices and compliance levels.

Routinely used ventilation devices for newborn resuscitation can triple intended V_T and requires further investigation.