Background: Neonatal resuscitation guidelines do not specify the gas flow rate during mask ventilation. Aim: Investigating the effect of gas flow rates on pressures, volumes delivered and mask leak. Methods: Flow 5 and 10 liters/min were tested. In study part 1, pressure ranges were measured when ventilating an intubated manikin with a Neopuff®. In study part 2, pediatric staff mask-ventilated a manikin (peak inflation pressure (PIP) 30 cm H2O, positive end expiratory pressure (PEEP) 5 cm H2O). We measured pressures, expired tidal volume (VTe) and mask leak. Results: Study part 1:an intubated manikin was ventilated with flow 5 versus 10 liters/min: range in PEEP was 0.4–3.6 and 2–14 cm H2O, respectively, maximum PIP was 73 cm H2O with both flow rates. Study part 2: when mask ventilation was given with flow 5 versus 10 liters/min: leak decreased (24% (8–85) vs. 80% (34– 94); p < 0.0001), VTe increased (6.7 (5.1–7.8) vs. 4.7 (2.4–7.0) ml; p < 0.001), PEEP decreased (3.1 (0.8) vs. 3.7 (0.7) cm H2O; p < 0.001), PIP was similar (28.1 (2.7) vs. 28.0 (2.3) cm H2O; NS). Large leaks decreased VTe and PEEP during both flow rates, PIP only with flow 5 liters/min. Conclusion: A low flow rate during neonatal mask ventilation may be a good alternative approach in reducing mask leak, provided that inflation time and flow rate warrants set pressures. Only large leaks seem to influence delivered pressures and volumes. Before resuscitation guidelines are advised, more studies on gas flow rates are needed.
Intentional substitution of food ingredients and misleading or false declarations of food products can lead to large economic damage in the food sector. An example is the truffle, an edible mushroom, with different species having a similar morphology. This makes it difficult to distinguish, for example, the high‐quality black Périgord truffle from Europe and the lower quality black truffle from China. To detect and prevent potential food fraud and to be able to carry out quality assurance measures, the demand for suitable, fast and cost‐effective examination methods for individual foodstuffs is increasing. In this article we present a method based on matrix‐assisted laser desorption/ionization time‐of‐flight mass spectrometry (MALDI‐TOF MS), which can differentiate and identify commercial truffles. For this purpose, highly specific mass spectrometric fingerprints of 73 truffle tubers from eight different species were generated. These were checked and compared under the criteria of a score evaluation, their protein spectra, and cluster formation. Standard laboratory equipment was used for this purpose, so that apart from the MALDI‐TOF no expensive equipment or reagents were required. The study shows that the MALDI‐TOF MS method can distinguish and identify Tuber spp. reliably, quickly and efficiently and can therefore be used for quality assurance and fraud control in the truffle market.
Aim:To investigate the efficiency of mask ventilation in preterm infants after birth. Methods:Recordings of airway pressures and gas flow of infants < 32 weeks gestation needing mask ventilation at birth were reviewed. Respiratory support was delivered with a T-piece and mask. Inflations in the first 5 minutes were analyzed for significant leak (> 60%), low expired tidal volume (V Te ) < 3.0 ml/kg, high V Te (> 15 ml/kg in initial sustained inflations of 3 seconds, > 10 ml/kg in subsequent inflations). Airway obstruction could only be observed leak was minimal. Results:Recordings of 26 infants (mean (SD) gestation 28.0 (1.6) weeks, birth weight 1120 (322) grams) were suitable for analysis.In 26 infants 130 sustained inflations (5 (2) per infant) were given and median (IQR) leak was 84 (40-100)% and V Te was 2.1 (0-6.7) ml/kg. In 20/26 infants 1513 subsequent inflations (75 (50) per infant) were given and leak was 56 (8-100)% and V Te 2.9 (0.3-5.8) ml/kg.The proportion of infants and percentage of inflations with significant leak, low V Te , high V Te and obstruction are shown in Table 1.
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