Centre for the Studies of Asphyxia and Resuscitation, Neonatal Research Unit, Royal Alexandra Hospital, Edmonton, Alberta, Canada; Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada.
Department of Obstetrics and Gynaecology, University of Cambridge, United Kingdom.
Semin Perinatol. 2019 Dec;43(8):151177. doi: 10.1053/j.semperi.2019.08.006. Epub 2019 Aug 17.
Immediately after birth through spontaneous breaths, infants' clear lung liquid replacing it with air, and gradually establishing a functional residual capacity to achieve gas exchange. Most infants start breathing independently after birth and ~3% of infants who require positive pressure ventilation. When newborns fail to start breathing the current neonatal resuscitation guidelines recommend initiatingpositive pressure ventilationusing a face mask and a ventilation device. Adequate ventilation is the cornerstone of successful neonatal resuscitation; therefore, it is mandatory that anybody involved in neonatal resuscitation is trained in mask ventilation techniques. One of the main problems with mask ventilation is that it is very subjective with direct feedback lacking and not uncommonly, the resuscitator does not realise that their technique is unsatisfactory. Many studies have shown that monitoring tidal volume and leak around the mask or endotracheal tube enables the resuscitator to identify the problem and adjust their technique to reduce the leak and deliver and appropriate tidal volume. This chapter discusses the currently available monitoring devices used during stabilization/resuscitation in the delivery room.
婴儿出生后通过自主呼吸，将肺内的清亮液体替换为空气，并逐渐建立功能残气量以实现气体交换。大多数婴儿在出生后会自主呼吸，但仍有~3%的婴儿需要正压通气。当新生儿无法开始呼吸时，目前的新生儿复苏指南建议使用面罩和通气设备进行正压通气。充足的通气是新生儿复苏成功的基石；因此，参与新生儿复苏的任何人都必须接受面罩通气技术的培训。面罩通气的主要问题之一是它非常主观，缺乏直接反馈，而且经常出现复苏者没有意识到自己的技术不令人满意的情况。许多研究表明，监测潮气量和面罩或气管内管周围的泄漏可以使复苏者识别问题，并调整技术以减少泄漏并提供适当的潮气量。本章讨论了目前在产房稳定/复苏过程中使用的监测设备。
