Neonatal ventilation with a manikin model and two novel PEEP valves without an external gas source

Thallinger, Monica; Ersdal, Hege; Morley, C J; Purington, Carolyn; Gomo, Øystein; Mduma, Estomih; Eilevstjønn, Joar; Størdal, Ketil

doi:10.1136/archdischild-2016-310955

Cited by 5 publications

(9 citation statements)

References 31 publications

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“…We did not record the respiratory system compliance in this experiment but expect it was within the range of 0.2–0.3 mL/kg/cmH 2 O, as shown previously 39. Compliance affects PEEP delivery: Tracy et al 18 tested 0.5 and 3 mL/cmH 2 O, and Thallinger et al 21 tested 0.1–0.2 and 0.8 mL/cmH 2 O. At a set PEEP of 5 cmH 2 O, both studies showed better PEEP provision with higher compliance (mean delivered PEEP increased by 0.8 and 0.6 cmH 2 O, respectively).…”

Section: Discussionmentioning

confidence: 54%

“…The paired models that perform closest to these requirements are Ambu and Mayo Healthcare, which provide more reliable mean PEEP in the absence of leak, according to this and previous17 18 studies. The Laerdal Upright Resuscitator has the advantage of an inbuilt PEEP valve and also provides less PEEP decay21; however, only fixed levels of PEEP (5 or 10 cmH 2 O) can be set, and its availability at the time of our study was restricted 38…”

Section: Discussionmentioning

confidence: 99%

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Delivery of positive end-expiratory pressure to preterm lambs using common resuscitation devices

Thió

Dawson²,

Crossley

et al. 2018

Arch Dis Child Fetal Neonatal Ed

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Section: Discussionmentioning

confidence: 54%

Section: Discussionmentioning

confidence: 99%

Delivery of positive end-expiratory pressure to preterm lambs using common resuscitation devices

Thió

Dawson²,

Crossley

et al. 2018

Arch Dis Child Fetal Neonatal Ed

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“…The first study assessed the performance of the devices analysing videos of participants ventilating a manikin using an upright device compared to the standard device (33) . The second trial found that the vertical device offered higher volumes and lower mask leakage compared to the standard in a manikin model (34) . The third study developed a trial in Tanzania to compare both devices, and it founds relevant results favouring the upright device (35) .…”

Section: Discussionmentioning

confidence: 99%

“…We have not found studies evaluating prototypes similar to ours. However, in 2017, the results of the evaluation of the performance and acceptability of a self-inflating neonatal bag for vertical use were published compared to the conventional design for use in the standard transverse position (33)(34)(35) . The first study assessed the performance of the devices analysing videos of participants ventilating a manikin using an upright device compared to the standard device (33) .…”

Section: Discussionmentioning

confidence: 99%

Non-clinical performance and acceptability of a small portable respiratory stimulator device for basic neonatal resuscitation

et al. 2019

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Introduction: Neonatal resuscitation demands equipment for respiratory support not always available in rural areas. Innovative devices are required, and rapid prototyping allows to generate them using three-dimensional (3D) designs and printers. Objective: To evaluate the non-clinical performance and the acceptability by health personnel of a neonatal respiratory device produced by rapid prototyping. Methods: Observational study, descriptive, of proof of concept developed in two steps. Step 1: Manufacture of the device with rapid prototyping in three-dimensional (3D) scanners and printers. Step 2: Demonstration of the invention during training programs in neonatal resuscitation for health personnel in three regions of Peru (Tarapoto, Huánuco and Ayacucho). In both steps, we evaluated the performance of the device connected to a gas flow analyser. A survey was administered to the health workers of Tarapoto and Ayacucho to know their acceptability. Results: The developed prototype is T-shaped with two side bellows that, when pressed with one hand, project air through the centre towards a facial adapter. The use of the prototype in the laboratory generated an average air flow of 4.8 Lt /min (SD ± 1.7) and an average pressure of 5.9 cmH2O (SD ± 1.4). This device was considered to be “very simple to use” in an acceptability survey involving 39 nurses and 11 doctors in remote areas of the capital of Peru. Conclusions: The evaluated prototype is acceptable by the staff and has a performance capable of generating spontaneous breathing at birth.

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“…We used binary regression with log-link function to estimate relative risks for ENM by time [13,15]. Risk factors which changed over time and were associated with the outcome (p<0.10) were included in a multivariate regression model if they changed the relative risk estimates by >10%.…”

Section: Methodsmentioning

confidence: 99%

Increased perinatal survival and improved ventilation skills over a five-year period: An observational study

Størdal¹,

Eilevstjønn²,

Mduma³

et al. 2020

PLoS ONE

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Background and aim The Helping Babies Breathe program gave major reductions in perinatal mortality in Tanzania from 2009 to 2012. We aimed to study whether this effect was sustained, and whether resuscitation skills changed with continued frequent training. Methods We analysed prospective data covering all births (n = 19,571) at Haydom Lutheran Hospital in Tanzania from July 2013-June 2018. Resuscitation training was continued during this period. All deliveries were monitored by an observer recording the timing of events and resuscitation interventions. Heart rate was recorded by dry-electrode ECG and bag-maskventilation by sensors attached to the resuscitator device. We analyzed changes over time in outcomes, use of resuscitation interventions and performance of resuscitation using binary regression models with the log-link function to obtain adjusted relative risks. Results With introduction of user fees for deliveries since 2014, the number of deliveries decreased by 30% from start to the end of the five-year period. An increase in low heart rate at birth and need for bag-mask-ventilation indicate a gradual selection of more vulnerable newborns delivered in the hospital over time. Despite this selection, newborn deaths <24 hours did not change significantly and was maintained at an average of 8.8/1000 live births. The annual reductions in relative risk for perinatal death adjusted for vulnerability factors was 0.84 (95%CI 0.76-0.94). During the five-year period, longer duration of bag-mask ventilation sequences without interruption was observed. Delivered tidal volumes were increased and mask leak was decreased during ventilation. The time to initiation or total duration of ventilation did not change significantly.

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Neonatal ventilation with a manikin model and two novel PEEP valves without an external gas source

Abstract: PEEP between 4 cm HO and 5 cm HO was achieved when ventilating a neonatal manikin using a self-inflating bag and novel PEEP valves. Valves that can generate PEEP without external gas sources may aid resuscitation in resource-limited settings.

Cited by 5 publications

References 31 publications

Delivery of positive end-expiratory pressure to preterm lambs using common resuscitation devices

Delivery of positive end-expiratory pressure to preterm lambs using common resuscitation devices

Non-clinical performance and acceptability of a small portable respiratory stimulator device for basic neonatal resuscitation

Increased perinatal survival and improved ventilation skills over a five-year period: An observational study

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