The Science Journal of the American Association for Respiratory Care

2009 OPEN FORUM Abstracts

COMPARISON OF FREQUENCIES DELIVERED DURING MANUAL VENTILATION WITH TWO T-PIECE RESUSCITATION DEVICES: A BENCH STUDY

John T. Gallagher, Christopher M. Joyce, Kathleen M. Deakins; Pediatric Respiratory Care, University Hospitals, Rainbow Babies & Children’s Hospital, Cleveland, OH

Introduction: The t-piece resuscitator (TPR) is a device used for manual ventilation of neonates in the delivery room, neonatal intensive care unit, and during patient transport. The TPR is beneficial for delivery of consistent ventilating pressures; but, a wide variance in caregiver initiated ventilation frequencies has been identified (Deakins, 2008). Recent advances in the design of the TPR have led to the addition of a metronome to aid in controlling the variation in caregiver-initiated frequencies. The purpose of this evaluation was to determine whether a TPR with metronome, the NeoPIP (Neoforce Group, Ivyland, PA), could reduce the variation in caregiver-initiated ventilation frequencies when compared to a TPR without a metronome; the NeoPuff (Fisher-Paykal, Aukland, New Zealand). Methods: 50 caregivers experienced in TPR from multiple disciplines including respiratory therapists, nurses, and physicians were selected to participate. The NeoPuff and the NeoPIP TPR’s were driven by an 8 Lpm source gas and both were connected to an Infant Star test lung with a fixed compliance of 1 mL/cm H20. Caregivers were first directed to simulate manual ventilation with the TPR without a metronome at a frequency of 30 bpm. The caregiver was given 15 seconds to achieve a rhythm, then the frequency was recorded for 60 seconds. The NeoPIP, a TPR with metronome, was then introduced and explained. A frequency of 30 was set on the metronome and the test was repeated. Frequencies for both devices were hand-counted and recorded by the investigator while time was kept with a digital timer. Results: Data were recorded as actual values of breaths per minute at the end of the 60-second period. Paired t-tests were used to determine consistency and error in the data sets from each device. Statistical significance was set at p<0.001. The consistency of the TPR without metronome was 38.2 +/- 9.5 while the TPR with metronome was 30.4 +/- 1.7 (p< 0.001). Accuracy in achieving the targeted rates was determined by subtracting the targeted rate from the mean values from each device or +8.2 without metronome and +0.2 with metronome (p< 0.001). Conclusions: In this simulation of manual ventilation with a TPR, caregiver accuracy and consistency were both improved with the addition of a metronome. Sponsored Research - None

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