Neonatal Intensive Care Unit, Westmead Hospital, Westmead, New South Wales, Australia
Department of Paediatrics and Child Health, The University of Sydney, Sydney, New South Wales, Australia.
Arch Dis Child Fetal Neonatal Ed. 2021 Jan;106(1):25-30. doi: 10.1136/archdischild-2019-318673. Epub 2020 Jun 16.
BACKGROUND: T-piece resuscitators (TPRs) are used for primary newborn resuscitation in birthing and emergency rooms worldwide. A recent study has shown spikes in peak inflation pressure (PIP) over set values with two brands of TPRs inbuilt into infant warmer/resuscitation platforms. We aimed to compare delivered ventilation between two TPR drivers with inflation pressure spikes to a standard handheld TPR in a low test lung compliance (Crs), leak-free bench test model. METHODS: A single operator provided positive pressure ventilation to a low compliance test lung model (Crs 0.2-1 mL/cmHO) at set PIP of 15, 25, 35 and 40 cmHO. Two TPR devices with known spikes (Draeger Resuscitaire, GE Panda) were compared with handheld Neopuff (NP). Recommended settings for positive end-expiratory pressure (5 cmHO), inflation rate of 60/min and gas flow rate 10 L/min were used. RESULTS: 2293 inflations were analysed. Draeger and GE TPR drivers delivered higher mean PIP (Panda 18.9-49.5 cmH2O; Draeger 21.2-49.2 cmH2O and NP 14.8-39.9 cmH2O) compared with set PIP and tidal volumes (TVs) compared with the NP (Panda 2.9-7.8 mL; Draeger 3.8-8.1 mL; compared with NP 2.2-6.0 mL), outside the prespecified acceptable range (±10% of set PIP and ±10% TV compared with NP). CONCLUSION: The observed spike in PIP over set values with Draeger and GE Panda systems resulted in significantly higher delivered volumes compared with the NP with identical settings. Manufacturers need to address these differences. The effect on patient outcomes is unknown.
背景：T 型复苏器（TPR）在全球的产房和急救室中被用于新生儿的初步复苏。最近的一项研究表明，在婴儿保温/复苏平台内置的两种 TPR 品牌中，峰值充气压力（PIP）超过设定值会出现峰值。我们旨在比较两种 TPR 驱动装置与标准手持 TPR 在低顺应性肺（Crs）、无泄漏台架测试模型中的输送通气情况。
方法：一名操作人员在设定的 PIP 为 15、25、35 和 40 cmHO 的情况下，向顺应性低的测试肺模型（Crs 0.2-1 mL/cmHO）提供正压通气。比较两种已知有峰值的 TPR 装置（Draeger Resuscitaire、GE Panda）与手持 Neopuff（NP）。推荐的正呼气末压（5 cmHO）、充气率为 60/min 和气体流量为 10 L/min 的设置用于测试。
结果：分析了 2293 次充气。与设定的 PIP 相比，Draeger 和 GE TPR 驱动装置提供的平均 PIP 更高（Panda 18.9-49.5 cmH2O；Draeger 21.2-49.2 cmH2O 和 NP 14.8-39.9 cmH2O），与 NP 相比，潮气量（TVs）也更高（Panda 2.9-7.8 mL；Draeger 3.8-8.1 mL；与 NP 相比为 2.2-6.0 mL），超出了预设的可接受范围（与 NP 相比，设定的 PIP 和 TV 的±10%）。
结论：Draeger 和 GE Panda 系统中观察到的 PIP 超过设定值的峰值导致输送的体积明显高于 NP 设定的相同值。制造商需要解决这些差异。对患者结果的影响尚不清楚。
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