Bibl Katharina, Wagner Michael, Dvorsky Robyn, Haderer Moritz, Strasser Lena, Berger Angelika, Ades Anne, Castera Mark, Gross Isabel T, Nishisaki Akira
Division of Neonatology, Pediatric Intensive Care and Neuropediatrics, Department of Pediatrics, Comprehensive Center for Pediatrics, Medical University of Vienna, Vienna, Austria.
Division of Neonatology, Pediatric Intensive Care and Neuropediatrics, Department of Pediatrics, Comprehensive Center for Pediatrics, Medical University of Vienna, Vienna, Austria.
J Pediatr. 2025 Jul;282:114568. doi: 10.1016/j.jpeds.2025.114568. Epub 2025 Mar 28.
To assess whether the two-person ventilation technique during simulated neonatal resuscitation enables higher ventilation quality compared with the one-person technique, as measured by expiratory tidal volume (eV), mask leak, positive inspiratory pressure, respiratory rate, and minute ventilation.
We conducted a randomized, cross-over simulation trial including 74 neonatal care providers at the Neonatal Simulation Center, Children's Hospital of Philadelphia. Participants performed bag-mask ventilation using one-person and two-person techniques in a randomized order. Ventilation parameters were recorded using a respiratory function monitor. Visual attention was analyzed using eye-tracking technology. The primary outcome was the time to achieve effective ventilation defined by eV between 4-8 ml/kg and mask leak ≤30% for 10 consecutive seconds.
No participant achieved the primary ventilation target in either technique. The two-person technique showed higher eV (9.7 mL/kg vs 8.4 mL/kg, absolute difference -1.3 mL/kg, 95% CI [-2.4, -0.1], P = .032) and a significant reduction in mask leak (48.9% vs 62.9%, absolute difference of 14.0%, 95% CI [6.4, 22.0], P < .001). Eye-tracking indicated differing visual attention patterns between techniques, with the two-person technique focusing more on the mask and bag (dwell time: 25% one-person vs 34% two-person, P = .13).
The two-person ventilation technique was associated with increased eV and decreased mask leak during simulated neonatal resuscitation. Further research is needed to evaluate the impact of different ventilation devices and techniques in clinical settings.
Since this was a simulation-based study, registration in a clinical trial registry was not required.
评估在模拟新生儿复苏过程中，双人通气技术与单人通气技术相比，是否能通过呼气潮气量（eV）、面罩漏气、吸气正压、呼吸频率和分钟通气量衡量出更高的通气质量。
我们在费城儿童医院新生儿模拟中心进行了一项随机交叉模拟试验，纳入了74名新生儿护理人员。参与者以随机顺序使用单人及双人技术进行面罩通气。使用呼吸功能监测仪记录通气参数。使用眼动追踪技术分析视觉注意力。主要结局是达到有效通气的时间，有效通气定义为eV在4 - 8 ml/kg之间且面罩漏气连续10秒≤30%。
两种技术中均无参与者达到主要通气目标。双人技术显示出更高的eV（9.7 mL/kg对8.4 mL/kg，绝对差值 -1.3 mL/kg，95% CI [-2.4, -0.1]，P = 0.032）且面罩漏气显著减少（48.9%对62.9%，绝对差值14.0%，95% CI [6.4, 22.0]，P < 0.001）。眼动追踪表明两种技术的视觉注意力模式不同，双人技术更关注面罩和呼吸袋（注视时间：单人技术为25%，双人技术为34%，P = 0.13）。
在模拟新生儿复苏过程中，双人通气技术与eV增加及面罩漏气减少相关。需要进一步研究以评估不同通气设备和技术在临床环境中的影响。
由于这是一项基于模拟的研究，无需在临床试验注册机构进行注册。
