Applied forces with high vs. low resuscitation table during neonatal ventilation: a randomized crossover manikin...

Area of Science:

• Neonatal Resuscitation
• Pediatric Airway Management
• Clinical Engineering

Background:

• Higher forces during neonatal face mask ventilation may increase apnea and bradycardia in preterm infants.
• Resuscitation table height is a potential factor influencing ventilation quality and applied forces.

Purpose of the Study:

• To compare applied forces, cuff pressure, and air leak during positive pressure ventilation using high vs. low resuscitation table positions.
• To evaluate the impact of resuscitation table height on neonatal manikin face mask ventilation parameters.

Main Methods:

• A randomized controlled crossover trial (AB/BA) was conducted using a neonatal manikin.
• Participants performed face mask ventilation with the resuscitation table at two heights: operator's xiphoid (high) and operator's navel (low).
• Measurements included applied forces (chin, cheekbone, nose bridge), cuff pressure, and mask leak percentage.

Main Results:

• Higher forces were recorded on the manikin's face with the high resuscitation table.
• Both median and top 10th percentile cuff pressures were elevated with the high table.
• No significant difference in ventilation time with less than 25% mask leak was observed between table heights.

Conclusions:

• A lower resuscitation table position (operator's navel) may reduce applied forces during neonatal positive pressure ventilation in a manikin model.
• Clinical validation is necessary to confirm the benefits of lower table positioning in actual patient care.
• Further research is warranted to assess the real-world impact on infant outcomes.