Randomised study of a new inline respiratory function monitor (Juno) to improve mask seal and delivered ventilation with neonatal manikins.

Autor:	Tracy MB; Westmead Hospital, Sydney, New South Wales, Australia mark.tracy@sydney.edu.au.; Department of Paediatrics and Child Health, Sydney University, Sydney, New South Wales, Australia., Hinder M; Department of Paediatrics and Child Health, Sydney University, Sydney, New South Wales, Australia.; Neonatal Intensive Care Unit, Westmead Hospital, Sydney, New South Wales, Australia., Morakeas S; Neonatal Intensive Care Unit, Westmead Hospital, Sydney, New South Wales, Australia.; Sydney University, Sydney, New South Wales, Australia., Lowe K; Newborn Intensive Care Unit, Westmead Hospital, Sydney, New South Wales, Australia., Priyadarshi A; Neonatal Intensive Care Unit, Westmead Hospital, Sydney, New South Wales, Australia., Crott M; Sydney University, Sydney, New South Wales, Australia., Boustred M; Sydney University, Sydney, New South Wales, Australia., Culcer M; Neonatal Intensive Care Unit, Westmead Hospital, Sydney, New South Wales, Australia.
Jazyk:	angličtina
Zdroj:	Archives of disease in childhood. Fetal and neonatal edition [Arch Dis Child Fetal Neonatal Ed] 2024 Aug 16; Vol. 109 (5), pp. 535-541. Date of Electronic Publication: 2024 Aug 16.
DOI:	10.1136/archdischild-2023-326256
Abstrakt:	Background: Respiratory function monitors (RFMs) have been used extensively in manikin and infant studies yet have not become the standard of training. We report the outcomes of a new portable, lightweight RFM, the Juno, designed to show mask leak and deflation tidal volume to assist in positive pressure ventilation (PPV) competency training using manikins. Methods: Two leak-free manikins (preterm and term) were used. Participants provided PPV to manikins using two randomised devices, self-inflating bag (SIB) and T-piece resuscitator (TPR), with Juno display initially blinded then unblinded in four 90 s paired sequences, aiming for adequate chest wall rise and target minimal mask leak with appropriate target delivered volume when using the monitor. Results: 49 experienced neonatal staff delivered 15 569 inflations to the term manikin and 14 580 inflations to the preterm. Comparing blinded to unblinded RFM display, there were significant reductions in all groups in the number of inflations out of target range volumes (preterm: SIB 22.6-6.6%, TPR 7.1-4.2% and term: SIB 54.8-37.8%, TPR 67.2-63.8%). The percentage of mask leak inflations >60% was reduced in preterm: SIB 20.7-7.2%, TPR 23.4-7.4% and in term: SIB 8.7-3.6%, TPR 23.5-6.2%). Conclusions: Using the Juno monitor during simulated resuscitation significantly improved mask leak and delivered ventilation among otherwise experienced staff using preterm and term manikins. The Juno is a novel RFM that may assist in teaching and self-assessment of resuscitation PPV technique. Competing Interests: Competing interests: The ResusRight is a startup company founded by MBT, MH, MCrott and M B to commercialise the prototype Juno monitor studied. MT is an unpaid medical consultant for the ResusRight and a minor share holder. MH is an unpaid engineering consultant for the ResusRight and a minor share holder. MCrott is a director and chief technical officer for ResusRight and is a shareholder. MB is a director chief executive officer for ResusRight and is a shareholder. (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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