Effect of two different chest compression techniques on ventilation during neonatal resuscitation

Area of Science:

• Neonatal Resuscitation
• Cardiopulmonary Physiology
• Pediatric Emergency Medicine

Background:

• Effective ventilation is critical during neonatal cardiopulmonary resuscitation (CPR).
• Different chest compression techniques may impact ventilation parameters.
• Optimizing tidal volume (Vt) and minute ventilation (MV) is essential for successful resuscitation outcomes.

Purpose of the Study:

• To compare the effectiveness of two-finger technique (TFT) versus two-thumb technique (TTT) for chest compressions during neonatal CPR.
• To assess the impact of these techniques on tidal volume (Vt) and minute ventilation (MV).

Main Methods:

• A neonatal manikin model was used to simulate intubated resuscitation.
• Thirty participants performed TFT and TTT in random order for 2-minute periods.
• Ventilation was delivered using a T-piece resuscitator (TPR) or a self-inflating bag (SIB), with Vt and MV continuously measured.

Main Results:

• TFT resulted in significantly higher Vt compared to TTT when using either TPR (44.9 ± 4.3 ml vs 39.2 ± 5.4 ml) or SIB (39.2 ± 5.7 ml vs 35.6 ± 6.5 ml).
• Minute ventilation (MV) was also significantly higher with TFT than TTT, both with TPR (1346 ± 130 ml/min vs 1175 ± 162 ml/min) and SIB (1177 ± 170 ml/min vs 1069 ± 196 ml/min).

Conclusions:

• The two-finger technique (TFT) demonstrated superior performance in achieving higher tidal volume and minute ventilation during simulated neonatal CPR compared to the two-thumb technique (TTT).
• These findings suggest that TFT may be a more effective chest compression method for optimizing ventilation during neonatal resuscitation.