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不同的T形管复苏器、自动充气式气囊和配备压力计的自动充气式气囊在适应通气设置变化所需的时间上有显著差异。

Time to adjust to changes in ventilation settings varies significantly between different T-piece resuscitators, self-inflating bags, and manometer equipped self-inflating bags.

作者信息

Hartung Julia C, Dold Simone K, Thio Marta, tePas Arjan, Schmalisch Gerd, Roehr Charles Christoph

机构信息

Department of Neonatology, Charité University Medical Center, Berlin, Germany.

Department of Newborn Research, The Royal Women's Hospital, Melbourne, Australia.

出版信息

Am J Perinatol. 2014 Jun;31(6):505-12. doi: 10.1055/s-0033-1354562. Epub 2013 Sep 2.

Abstract

OBJECTIVE

Resuscitation guidelines give no preference over use of self-inflating bags (SIBs) or T-piece resuscitators (TPR) for manual neonatal ventilation. We speculated that devices would differ significantly regarding time required to adjust to changed ventilation settings.

STUDY DESIGN

This was a laboratory study. Time to adjust from baseline peak inflation pressure (PIP) (20 cmH2O) to target PIP (25 and 40 cmH2O), ability to adhere to predefined ventilation settings (PIP, PEEP, and inflation rate [IR]), and the variability within and between operators were assessed for a SIB without manometer, SIB with manometer (SIBM), and two TPRs.

RESULTS

Adjustment time was significantly longer with TPRs, compared with SIB and SIBM. The SIBM and TPRs were < 5% (median) off target PIP, and the SIB was 14% off target PIP. Significant variability between operators (interquartile range [IQR]: 71%) was seen with SIBs.

CONCLUSION

PIP adjustment takes longer with TPRs, compared with SIB/SIBM. TPRs and SIBM allow satisfactory adherence to ventilation parameters. SIBs should only be used with manometer attached.

摘要

目的

复苏指南对于新生儿手动通气时使用自动充气式气囊(SIB)或T组合复苏器(TPR)未给出偏好建议。我们推测,在调整至改变后的通气设置所需时间方面,这两种设备会有显著差异。

研究设计

这是一项实验室研究。评估了无压力计的SIB、有压力计的SIB(SIBM)以及两种TPR从基线峰值吸气压力(PIP)(20cmH₂O)调整至目标PIP(25和40cmH₂O)所需的时间、遵循预定义通气设置(PIP、呼气末正压[PEEP]和充气速率[IR])的能力以及操作者之间和操作者内部的变异性。

结果

与SIB和SIBM相比,TPR的调整时间显著更长。SIBM和TPR偏离目标PIP的幅度<5%(中位数),而SIB偏离目标PIP的幅度为14%。使用SIB时,操作者之间存在显著变异性(四分位间距[IQR]:71%)。

结论

与SIB/SIBM相比,TPR的PIP调整时间更长。TPR和SIBM能够令人满意地遵循通气参数。SIB仅应在附有压力计的情况下使用。

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