Tidal volume monitoring during emergency neonatal transport

Area of Science:

• Neonatal Resuscitation
• Pediatric Transport Medicine
• Respiratory Physiology

Background:

• Positive pressure ventilation is critical for infants requiring respiratory support during transport.
• Accurate delivery of tidal volumes is essential for optimal neonatal outcomes.
• Clinical assessment of ventilation efficacy during transport is often unreliable.

Purpose of the Study:

• To determine the frequency of achieving target tidal volumes in infants receiving positive pressure ventilation during emergency transport.
• To evaluate the accuracy of ventilation parameters in a real-world transport setting.

Main Methods:

• A prospective observational study was conducted on infants requiring positive pressure ventilation during emergency transport.
• Data on tidal volume delivery (below, in, and above target range of 4-6 mL/kg) were blindly recorded and analyzed.
• Patients were monitored during delivery room to neonatal intensive care unit (NICU) and inter-facility transport.

Main Results:

• During delivery room transport, only 21% of patients achieved target tidal volumes >50% of the time, and 7% achieved it >90% of the time.
• During inter-hospital transport, 60% of patients achieved target tidal volumes >50% of the time, and 7% achieved it >90% of the time.
• A significant proportion of breaths were outside the desired tidal volume range during both transport scenarios.

Conclusions:

• Effective clinical assessment of ventilation is difficult during neonatal emergency transport.
• There is a critical need for enhanced respiratory monitoring during neonatal transport to guide clinical management.
• Further research and implementation of advanced monitoring tools are urgently required.