Ikuta Yasuhisa, Takatori Fumihiko, Amari Shoichiro, Ito Ai, Ishiguro Akira, Isayama Tetsuya
Division of Neonatology, Center for Maternal-Fetal, Neonatal and Reproductive Medicine, 13611 National Center for Child Health and Development , Setagaya-ku, Tokyo, Japan.
Nihon Kohden Corporation, Shinjyuku-ku, Tokyo, Japan.
J Perinat Med. 2024 Nov 26;53(2):249-257. doi: 10.1515/jpm-2024-0251. Print 2025 Feb 25.
To investigate the effectiveness of placing an indicator light indicating inadequate ventilation near the face mask during positive-pressure ventilation with respiratory function monitors (RFMs) in neonatal resuscitation. The study is a three-group, randomised, controlled, crossover simulation trial.
Paediatrics residents, neonatology fellows, and attending neonatologists at a single neonatal intensive care unit. A ventilation simulation with a manikin was performed three times consecutively using the same scenario with three different ventilation evaluation methods (A) RFM plus indicator light and conventional methods (heart rate and chest rise) (B) RFM and conventional methods, and (C) conventional methods alone.
The ratio of gaze duration on the manikin to the total trial duration was recorded using an eye-tracking device. The proportion of trials with adequate ventilation (expiratory tidal volume [VTe], 4-10 mL/kg; peak inspiratory pressure <30 cm HO; leak <40 %) was determined. After excluding incomplete data, 63 simulations (22 participants) were analysed. The ratios of the gaze duration on the manikin to the total trial duration were significantly different among settings A (0.60 [95 % confidence interval: 0.52-0.67] s/s), B (0.51 [0.43-0.59] s/s), and C (0.80 [0.76-0.84] s/s). Ventilation with adequate VTe and less leakage was more frequent in settings A and B than in setting C (adequate VTe: A, 91 %; B, 91 %; and C, 83 %; less leak: A, 76 %; B, 78 %; and C, 57 %).
An indicator light close to the facemask with an RFM directed the eyesight towards the manikin without compromising the ventilation quality during the simulation of neonatal resuscitation.
探讨在新生儿复苏过程中使用呼吸功能监测仪（RFM）进行正压通气时，在面罩附近放置指示通气不足的指示灯的有效性。该研究是一项三组随机对照交叉模拟试验。
来自单一新生儿重症监护病房的儿科住院医师、新生儿科研究员和新生儿科主治医师。使用同一个模拟场景，连续三次对模拟人进行通气模拟，采用三种不同的通气评估方法：（A）RFM加指示灯及传统方法（心率和胸廓起伏）；（B）RFM和传统方法；（C）仅使用传统方法。
使用眼动追踪设备记录注视模拟人的持续时间与总试验持续时间的比值。确定通气充足（呼气潮气量[VTe]，4 - 10 mL/kg；吸气峰压<30 cm H₂O；漏气<40%）的试验比例。排除不完整数据后，分析了63次模拟（22名参与者）。在A组（0.60[95%置信区间：0.52 - 0.67]秒/秒）、B组（0.51[0.43 - 0.59]秒/秒）和C组（0.80[0.76 - 0.84]秒/秒）中，注视模拟人的持续时间与总试验持续时间的比值存在显著差异。A组和B组中VTe充足且漏气较少的通气情况比C组更常见（VTe充足：A组91%；B组91%；C组83%；漏气较少：A组76%；B组78%；C组57%）。
在新生儿复苏模拟过程中，靠近面罩的指示灯与RFM一起使用，可将视线引向模拟人，且不影响通气质量。
