Comparison the efficacy of three positive pressure ventilation devices used by medicine students on a neonatal resuscitation simulators

Abstract

Background: Positive pressure ventilation is the most frequently used intervention for the resuscitation of newborns. It should guarantee pressures and volumes in safe and effective ranges to establish appropriate pulmonary ventilation and prevent pulmonary injury. The objective of this study was to compare the efficacy of ventilation of three manual PPV devices used on a neonatal resuscitation simulator by medical students. Methods: An experimental two-factor (device and student) study design with several replications of the experiment (a ventilation cycle performed by a student in one minute with each device) was used. Students in their last year of school of medicine at the Universidad de La Sabana were included. The data were collected using a pressure sensor. The peak inspiratory pressure (PIP), the positive end-expiratory pressure (PEEP) by ventilation, and the respiratory rate per minute were recorded for each participant. Pressure in safety range was used as efficacy endpoint. Results: 30 students were included in the study. With the self-inflating bag (SIB) and the flow-inflating bag, a higher percentage of PIP and PEEP was found to be ineffective. No device exceeded the maximum PIP. The use of the disposable T-piece resuscitator resulted in PIP within the safety range 3.20 times more frequently and in PEEP within the safety range 963.8 times more frequently compared with the SIB. Conclusions: The disposable T-piece resuscitator was found to be the most efficacy device for manual ventilation, when used by inexperienced personnel for neonatal resuscitation.