Self-inflating bags versus T-piece resuscitator to deliver sustained inflations in a preterm lamb model. Issue 4 (19th March 2014)

• Record Type: Journal Article
• Authors: Thio, M; Dawson, J A; Moss, T J; Galinsky, R; Rafferty, A; Hooper, S B; Davis, P G
• Is Part Of: Archives of disease in childhood. Volume 99:Issue 4(2014)
• Page Start: F274
• Page End: F277
• Publication Date: 2014-03-19
• Subjects: Infants -- Diseases -- Periodicals; Newborn infants -- Diseases -- Periodicals; Fetus -- Diseases -- Periodicals; 618.920105
• DOI: 10.1136/archdischild-2013-305239
• Languages: English
• ISSNs: 1359-2998

Abstract

Abstract : Objective: In neonatal resuscitation, the use of a sustained inflation (SI) may facilitate lung aeration. Previous studies comparing different resuscitation devices have shown that one model of self-inflating bag (SIB) could not deliver an SI. We aimed to compare the delivery of an SI using four SIBs with that of a T-piece. Study design: In intubated preterm lambs, we compared four models of SIB fitted with a positive end expiratory pressure (PEEP) valve to a T-piece using a gas flow of 8 L/min. Four operators aimed to deliver three SIs of 20 cm H2 O for 30 s. The study was repeated with the PEEP valve removed and again with no flow. We measured duration of SI, average inflation pressure (IP) and analysed the shape of the pressure curves. Results: 204 combinations were analysed. Mean (SD) duration of SI was Ambu 6(2)s, Laerdal 14(8)s, Parker Healthcare 5(1)s, Mayo Healthcare 33(2)s and T-piece 33(1)s. Mean (SD) average IP was Ambu 17(3)cm H2 O, Laerdal 17(3)cm H2 O, Parker Healthcare 12(5)cm H2 O, Mayo Healthcare 21(2)cm H2 O and T-piece 20(0)cm H2 O. Duration of SI and average IP was significantly different between SIBs (all p<0.001). The findings were substantially unchanged when PEEP valve and flow were removed (all p>0.05). Only the Mayo system delivered SIs with duration and average IP not significantly different from the T-piece (p>0.05). Conclusions: The performance of the four SIBs tested varied considerably. Some are able to deliver an SI even in the absence of gas flow. This may be useful in a resource-limited setting with no gas supply.