Impact of a Two-Person Mask Ventilation Technique During Neonatal Resuscitation: A Simulation-Based Randomized...

Area of Science:

• Neonatal Resuscitation
• Simulation-Based Medical Training
• Cardiopulmonary Physiology

Background:

• Bag-mask ventilation is a critical skill in neonatal resuscitation.
• Optimizing ventilation quality is essential for improving patient outcomes.
• Current guidelines recommend specific parameters for effective neonatal ventilation.

Purpose of the Study:

• To compare the effectiveness of two-person versus one-person bag-mask ventilation techniques.
• To evaluate ventilation quality metrics including expiratory tidal volume (eV_T) and mask leak.
• To assess visual attention patterns during simulated neonatal resuscitation.

Main Methods:

• A randomized, cross-over simulation trial was conducted with 74 neonatal care providers.
• Participants performed bag-mask ventilation using both one-person and two-person techniques.
• Ventilation parameters were measured using a respiratory function monitor; eye-tracking analyzed visual attention.

Main Results:

• No participant achieved the primary ventilation target (eV_T 4-8 ml/kg, mask leak ≤30%) with either technique.
• The two-person technique yielded higher eV_T (9.7 vs 8.4 mL/kg) and significantly reduced mask leak (48.9% vs 62.9%).
• Eye-tracking showed increased focus on the mask and bag with the two-person technique.

Conclusions:

• The two-person technique demonstrated improved eV_T and reduced mask leak in simulated neonatal resuscitation.
• Further research is necessary to explore the clinical impact of different ventilation devices and techniques.