The Science Journal of the American Association for Respiratory Care

2010 OPEN FORUM Abstracts

VARIABILITY AMONGST T-PIECE RESUSCITATION CIRCUITS: ARE ALL CIRCUITS CREATED EQUAL?

Kathleen Deakins, Sharon Estok, Timothy Myers; University Hospitals Rainbow Babies & Children’s, Cleveland, OH

Background T-piece resuscitation has gained popularity in the delivery room and in Neonatal Intensive Care Units in the last decade. Currently there are 3 commercially-available t-piece resuscitators and circuits used to achieve consistent inspiratory (PIP) and expiratory pressures (PEEP).Circuits aren’t typically interchanged with one another or tested on other resuscitator types. Frequently the devices are set-up prior to patient used by ancillary support staff. The purpose of this study was to determine if variability in PIP and PEEP existed when interchanging proprietary circuits with other resuscitators. Methods Four samples of each brand of t-piece circuits were attached to an Infant Star test lung (compliance 2mL/cmH20), the GE Panda Infant Resuscitator (GE Healthcare, Finland), Neopuff (Fisher and Paykel Auckland NZ) and NeoPIP (Neoforce Group Ivyland, PA) and tested at suggested inspiratory flows of 8LPM, 10LPM and 15LPM using the maximum pressure relief valve test. Resistor valves were not altered prior to testing and breath rate was manually cycled on at each flow rate. PIP and PEEP values were measured by the NICO monitor (Phillips, Andover, MA) using an infant flow sensor. Pressures from each series of circuits tested with the 3 inspiratory flows for each device were recorded. Results: Data are reported as mean values and standard deviations in the table below. Conclusion Dynamics of t-piece resuscitators with different resuscitation circuits are highly variable and can have drastic effects on inspiratory and expiratory delivered pressures within the manufacturer’s recommended flow ranges. Circuits should be tested and preset by skilled caregivers prior to clinical use. Sponsored Research - None

T-piece Circuit Pressures ( recorded in cm H2O)