The Westmead Hospital Neonatal Intensive Care Unit, Australia; The University of Sydney, Department of Paediatrics and Child Health, Australia.
The Westmead Hospital Neonatal Intensive Care Unit, Australia; The University of Sydney, Department of Paediatrics and Child Health, Australia.
Semin Fetal Neonatal Med. 2021 Apr;26(2):101233. doi: 10.1016/j.siny.2021.101233. Epub 2021 Mar 19.
Infant resuscitation devices used at birth must be capable of delivering adequate and consistent ventilation in a controlled and predictable manner to a wide patient weight range, and combinations of transitional lung states. Manual inflation resuscitation devices delivering positive pressure lung inflation at birth can be classified broadly into two types: 1) flow generating, ie silicone self-inflating bags (SIB) also known as bag valve mask (BVM) and 2) flow dependent, ie anaesthetic flow inflating bag (FIB) and t-piece resuscitator (TPR) systems (eg: Neopuff, GE Panda and Draeger Resuscitaires). Globalization, lower production costs, and an expanding market need for devices, has led to a proliferation of brands (both reusable and single use) within a class type. T-piece resuscitators have become the dominant device particularly in high income countries. There remains a paucity of information on the performance characteristics of these devices and their ability to provide the required respiratory parameters for effective and safe ventilation across the full-expected weight range and lung states to which they will be applied. This review aims to inform current clinical practise on the biomechanical efficiency, reliability and efficacy of the most common devices used to apply PPV to newborns and infants ≤10 kgs.
用于出生时的婴儿复苏设备必须能够以可控和可预测的方式向广泛的患者体重范围和过渡性肺状态组合提供足够和一致的通气。在出生时提供正压肺充气的手动充气复苏设备可大致分为两类：1）产生流量的，即硅酮自充气袋（SIB）也称为袋阀面罩（BVM）和 2）依赖流量的，即麻醉流量充气袋（FIB）和 T 型复苏器（TPR）系统（例如：新生儿复苏器、GE 熊猫和德尔格复苏器）。全球化、较低的生产成本以及设备市场的扩大需求，导致同一类型的设备品牌（可重复使用和一次性使用）大量增加。T 型复苏器已成为主导设备，特别是在高收入国家。这些设备的性能特征及其在整个预期体重范围和应用的肺状态下提供所需呼吸参数以实现有效和安全通气的能力的信息仍然很少。本综述旨在告知目前关于最常用于对新生儿和体重≤10kg 的婴儿应用 PPV 的设备的生物力学效率、可靠性和功效的临床实践。
