Respiratory function monitor guidance of mask ventilation in the delivery room: a feasibility study

Georg M Schmölzer, Colin J Morley, Connie Wong, Jennifer A Dawson, Camille Omar F Kamlin, Susan M Donath, Stuart B Hooper, Peter G Davis
Journal of Pediatrics 2012, 160 (3): 377-381.e2

OBJECTIVE: To investigate whether using a respiratory function monitor (RFM) during mask resuscitation of preterm infants reduces face mask leak and improves tidal volume (V(T)).

STUDY DESIGN: Infants receiving mask resuscitation were randomized to have the display of an RFM (airway pressure, flow, and V(T) waves) either visible or masked.

RESULT: Twenty-six infants had the RFM visible, and 23 had the RFM masked. The median mask leak was 37% (IQR, 21%-54%) in the visible RFM group and 54% (IQR, 37%-82%) in the masked RFM group (P = .01). Mask repositioning was done in 19 infants (73%) of the visible group and in 6 infants (26%) of the masked group (P = .001). The median expired V(T) was similar in the 2 groups. Oxygen was provided to 61% of the visible RFM group and 87% of the RFM masked group (P = .044). Continuous positive airway pressure use was greater in the visible RFM group (73% vs 43%; P = .035). Intubation in the delivery room was done in 21% of the visible group and in 57% of the masked group (P = .035).

CONCLUSION: Using an RFM was associated with significantly less mask leak, more mask adjustments, and a lower rate of excessive V(T).

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