The Science Journal of the American Association for Respiratory Care

2007 OPEN FORUM Abstracts

THE EFFECTS OF TUBING LENGTH ON PRESSURE DELIVERY OF TWO T-PIECE RESUSCITATOR CIRCUITS

K. Deakins1


Abstract body: Background T-Piece resuscitators are considered acceptable alternatives to bag mask ventilation, Neonatal Resuscitation Program Guidelines of 2006. Kattwinkel, J., Textbook of Neonatal Resuscitation 2006, 5:54-57. The considerable amount of equipment needed to care for neonates includes sophisticated composition of the headwall, ventilators, incubators, radiant warmers, and pumps, which creates challenges for easy access to the resuscitator. The purpose of this study is to determine if a longer t-piece resuscitator circuit can deliver comparable results to the gold standard Neopuff circuit. Methods Two t-piece resuscitator circuits, the Neopuff (Fisher/ Paykel Auckland, NZ) length: 1450mm and an investigational device, NeoPEEP, (Neoforce Inc., Ivyland, PA) length: 1685mm (plus inlet adapter)were alternately attached to a Neopuff Infant Resuscitator. The Neopuff was connected to a 3.0mm endotracheal tube and Infant Star Test lung (Infrasonics Inc), compliance set at 1mL/cm H20. Peak inspiratory pressure (PIP) 20 cm H20and positive end expiratory pressure (PEEP) 5 cm H20 were measured using the Breath Tracker 1705, (Sechrist Medical) at flows of 8,10,12, and 15 liters/minute. By setting the maximum pressure relief, PIP knobs and flow resistor fully clockwise and occluding both ends of the t-piece, maximum PIP and PEEP were determined. Measurements were made in triplicate for each experimental condition. Results The table below shows the mean (standard deviation) in cm H2O. There was no clinically important difference between the delivered PIP, PEEP or maximum PIP using either length of circuit. Conclusion Circuit length has no impact on the delivery of peak inspiratory pressure for these t-piece resuscitation devices. The NeoPEEP circuit’s flow resistor is less restrictive (looser) than the Neopuff’s and may account for larger ranges for PEEP. Either length of tubing may be used to accomplish effective resuscitation of neonates.

Device PIP PEEP Max PIP Max PEEP
Neopuff 20 (0) 5 (0) 75 (0) 24(9)
NeoPEEP 20 (0) 5.5(3) 75 (0) 34(4)



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