Manual neonatal ventilation training: a respiratory function monitor helps to reduce peak inspiratory pressures and tidal volumes during resuscitation
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Marcus Kelm
Abstract
Background: Neonatal resuscitation training is considered to be multifarious and includes manual ventilation as an essential competence for any health-care provider. Usually, ventilation is applied with self-inflating bags (SIBs). These devices have been shown to produce highly variable, operator-dependent peak inspiratory pressures (PIPs) and tidal volumes (VT). Excessive PIP and VT contribute to lung injury. We studied a simple tool to improve resuscitation skills.
Objective: The objectives of this study were to train health-care providers to avoid excessive PIP and VT by visualizing these values by using a respiratory function monitor (RFM) and to study the sustainability of such a training.
Material and methods: Previously untrained medical professionals were educated and trained to ventilate a neonatal preterm manikin. PIP and VT were measured with an RFM. Graphical representations of the measurements were displayed during training, but the RFM was blinded during subsequent recordings. Participants were reassessed directly after training and 1 month later.
Results: In total, 37 participants were trained and assessed three times during the study. Median PIPs (range) were 32.3 (4.1–44) cm H2O before training, 17.8 (9.6–23.6) cm H2O directly after training (P<0.05), and 18.7 (7.5–41.6) cm H2O 1 month later, and the values remained low, compared with before training (P<0.05). Median VTs were 6.7 (4.2–44) mL before training, 3.5 (1.8–7.3) mL directly after training (P<0.05), and 4.1 (1.9–9.7 mL) 1 month after training (P<0.05).
Conclusion: Using a SIB, untrained staff produced excessive PIP and VT. Training with a simple RFM significantly reduced the occurrence of excessive PIP and VT. The effect was sustained for at least 1 month.
©2012 by Walter de Gruyter Berlin Boston
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Artikel in diesem Heft
- Masthead
- Masthead
- Original Articles – Obstetrics
- Intravenous iron treatment in pregnancy: comparison of high-dose ferric carboxymaltose vs. iron sucrose
- Trophoblastic progranulin expression is upregulated in cases of fetal growth restriction and preeclampsia
- Can a customized standard for large for gestational age identify women at risk of operative delivery and shoulder dystocia?
- Can discordance in CRL at the first trimester predict birth weight discordance in twin pregnancies?
- Anxiety and deterioration of quality of life factors associated with recurrent miscarriage in an observational study
- Neonatal outcome in infants of patients with radical vaginal trachelectomy
- The prevalence of gestational diabetes in advanced economies
- First-trimester reference ranges for decidual thickness and its relation to progesterone levels
- Original Articles – Fetus
- Levels of cytokines in umbilical cord blood in relation to spontaneous term labor
- Survival and neonatal outcome after fetoscopic guided laser occlusion (FLOC) of twin-to-twin transfusion syndrome (TTTS) in Sweden
- Is it necessary to induce labor in cases of intrauterine growth restriction at term?
- Fetal myocardial peak systolic strain before and after intrauterine red blood cell transfusion – a tissue Doppler imaging study
- Delayed interval delivery in twin and triplet pregnancies: 6 years of experience in one perinatal center
- Original Articles – Newborn
- Rapid neonatal weight gain increases risk of childhood overweight in offspring of diabetic mothers
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