Bibl Katharina, Wagner Michael, Dvorsky Robyn, Haderer Moritz, Giordano Vito, Groepel Peter, Berger Angelika, Whitfill Travis, Kadhim Bashar, Auerbach Marc A, Gross Isabel T
Division of Neonatology, Pediatric Intensive Care and Neuropediatrics, Comprehensive Center for Pediatrics, Department of Paediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria
Division of Neonatology, Pediatric Intensive Care and Neuropediatrics, Comprehensive Center for Pediatrics, Department of Paediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria.
Arch Dis Child Fetal Neonatal Ed. 2025 Apr 17;110(3):334-340. doi: 10.1136/archdischild-2024-327483.
This study aimed to investigate whether distractions during simulated neonatal resuscitation impact mask leakage and visual gaze patterns during positive pressure ventilation (PPV) of a newborn manikin.
In this observational, simulation-based study, medical students and paediatric residents managed a neonate requiring resuscitation alongside a standardised team and executed PPV on a leak-free manikin. The scenario incorporated distractions such as chest compressions, preparation and insertion of an umbilical vein catheter, administering fluids and interpreting venous blood gas. Ventilation parameters were monitored using a respiratory function monitor, and participants were equipped with eye-tracking glasses to assess visual gaze patterns. Additionally, they self-assessed their level of distractions and estimated performance. Measures included dwell time, mask leak, minute volume and respiratory rate to determine whether PPV parameters and distractors were associated during times of interest (TOI).
We included 30 participants and observed statistically significant differences in the delivery of PPV parameters between TOIs with distractions compared with TOIs without distractions, as reflected in mask leak (31.0 vs 15.9 %), minute volume (202.0 vs 253.0 mL/kg/min) and respiratory rate (29.0 vs 33.0/min). Results on alterations in gaze behaviour showed a significant gaze shift from the infant's chest and airway to instruments and other areas of interest when distractions were present. During the venous blood gas interpretation, participants rated their performance worse than during other TOIs. Participants generally overrated their ventilation quality.
This study showed a significant impact of distractions on PPV parameters and visual attention during simulated neonatal resuscitation.
本研究旨在调查模拟新生儿复苏过程中的干扰因素是否会影响新生儿模型正压通气（PPV）时的面罩漏气情况和视觉注视模式。
在这项基于模拟的观察性研究中，医学生和儿科住院医师与一个标准化团队一起处理一名需要复苏的新生儿，并在无泄漏的模型上进行PPV。该场景包含了一些干扰因素，如胸外按压、脐静脉导管的准备和插入、输液以及解读静脉血气。使用呼吸功能监测仪监测通气参数，并为参与者配备眼动追踪眼镜以评估视觉注视模式。此外，他们对自己的分心程度和估计表现进行自我评估。测量指标包括停留时间、面罩漏气、分钟通气量和呼吸频率，以确定在感兴趣的时间段（TOI）内PPV参数与干扰因素之间是否存在关联。
我们纳入了30名参与者，观察到有干扰因素的TOI与无干扰因素的TOI相比，在PPV参数的提供方面存在统计学上的显著差异，这体现在面罩漏气（31.0%对15.9%）、分钟通气量（202.0对253.0毫升/千克/分钟）和呼吸频率（29.0对33.0/分钟）上。关于注视行为改变的结果显示，当存在干扰因素时，注视点从婴儿的胸部和气道显著转移到了仪器和其他感兴趣的区域。在解读静脉血气期间，参与者对自己表现的评分比其他TOI时更差。参与者总体上高估了他们的通气质量。
本研究表明，在模拟新生儿复苏过程中，干扰因素对PPV参数和视觉注意力有显著影响。
