Newborn Research Centre, The Royal Women's Hospital, Melbourne, Victoria, Australia.
Neonatal Research, Murdoch Children's Research Institute, Melbourne, Victoria, Australia.
Arch Dis Child Fetal Neonatal Ed. 2018 Nov;103(6):F562-F566. doi: 10.1136/archdischild-2017-313701. Epub 2017 Nov 30.
OBJECTIVE: Neonatal mask ventilation is a difficult skill to acquire and maintain. Mask leak is common and can lead to ineffective ventilation. The aim of this study was to determine whether newly available neonatal self-inflating bags and masks could reduce mask leak without additional load being applied to the face. DESIGN: Forty operators delivered 1 min episodes of mask ventilation to a mannequin using the Laerdal Upright Resuscitator, a standard Laerdal infant resuscitator (Laerdal Medical) and a T-Piece Resuscitator (Neopuff), using both the Laerdal snap-fit face mask and the standard Laerdal size 0/1 face mask (equivalent sizes). Participants were asked to use pressure sufficient to achieve 'appropriate' chest rise. Leak, applied load, airway pressure and tidal volume were measured continuously. Participants were unaware that load was being recorded. RESULTS: There was no difference in mask leak between resuscitation devices. Leak was significantly lower when the snap-fit mask was used with all resuscitation devices, compared with the standard mask (14% vs 37% leak, P<0.01). The snap-fit mask was preferred by 83% of participants. The device-mask combinations had no significant effect on applied load. CONCLUSIONS: The Laerdal Upright Resuscitator resulted in similar leak to the other resuscitation devices studied, and did not exert additional load to the face and head. The snap-fit mask significantly reduced overall leak with all resuscitation devices and was the mask preferred by participants.
目的:新生儿面罩通气是一项难以掌握和维持的技能。面罩泄漏很常见,会导致通气无效。本研究旨在确定新的新生儿自充气球囊和面罩是否可以减少面罩泄漏,而不会对面部施加额外的负荷。
设计:40 名操作人员使用 Laerdal 直立复苏器、标准 Laerdal 婴儿复苏器(Laerdal Medical)和 T 型复苏器(Neopuff),对模拟人进行 1 分钟的面罩通气,同时使用 Laerdal 卡扣式面罩和标准 Laerdal 尺寸 0/1 面罩(等效尺寸)。要求参与者使用足以产生“适当”胸廓上升的压力。连续测量泄漏、应用负荷、气道压力和潮气量。参与者不知道正在记录负荷。
结果:不同复苏设备之间的面罩泄漏没有差异。与标准面罩相比,使用卡扣式面罩时,所有复苏设备的泄漏量明显较低(14% 对 37% 的泄漏,P<0.01)。卡扣式面罩受到 83%的参与者的青睐。设备-面罩组合对应用负荷没有显著影响。
结论:Laerdal 直立复苏器的泄漏与研究中的其他复苏设备相似,不会对面部和头部施加额外的负荷。卡扣式面罩与所有复苏设备结合使用均可显著减少整体泄漏,并且是参与者首选的面罩。
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