Efficacy and user preference of two CO2 detectors in an infant mannequin randomized crossover trial
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Abstract
Assessment of effective ventilation in neonatal mask ventilation can be difficult. This study aims to determine whether manual ventilation with a T-piece resuscitator containing an inline CO2 detector (either a Pedi-Cap® CO2 detector or a Neo-StatCO2 <Kg® CO2 detector connected to a facemask) facilitates effective positive pressure ventilation compared to no device in a mannequin study. Paediatric and neonatal trainees were randomly assigned to determine which method they began with (no device, Pedi-Cap or a Neo-Stat). The participants used each method for a period of 3 min. They were video-recorded to determine the amount of effective ventilations delivered and the overall percentage efficiency of each method. Efficacy of ventilation was determined by comparing the number of manual ventilations delivered with the number of times chest rise was observed in the video recording. There were 19 paediatric trainees who provided a total of 7,790 ventilations, and 93% were deemed effective. The percentage of effective ventilations with the T-piece resuscitator alone, the PediCap and the NeoStat were 90, 94 and 96%, respectively. The difference was greatest in the first minute (T-piece resuscitator alone 87.5%, PediCap 94%, NeoStat 96%). Two thirds preferred the Neo-Stat. The use of a CO2 detector improves positive pressure ventilation in a mannequin model, especially in the first minute of positive pressure ventilation. The Neo-Stat CO2 detector was the preferred device by the majority of the participants.
Keywords
Colorimeter CO2 detector Mask ventilation Neonates Pedicap NeostatAbbreviations
- NRP
Neonatal Resuscitation Program
- IPPV
Intermittent positive pressure ventilation
- ETT
Endotracheal tube
- CUMH
Cork University Maternity Hospital
- HORIZ
Horizontally attached CO2 detector
- VERT
Vertically attached CO2 detector
- TPR
T-piece resuscitator
- SHO
Senior House Officer
Notes
Contributorship
Gavin Anthony Hawkes had primary responsibility for overall content and manuscript preparation. He was also involved with study design, data collection and data interpretation. Brian O'Connell was involved with mannequin design and maintenance of all devices used in the study. Vicki Livingstone was involved with the statistical analysis carried out in the study. Colin Hawkes was involved with study design and manuscript preparation. C. Anthony Ryan was involved with study design, data analysis and manuscript preparation. Eugene Michael Dempsey was the supervisor for this study. He was involved with overall content, study design, manuscript preparation, data collection and data interpretation.
Conflicts of interest
The authors of this study do not have any conflicts of interest to disclose.
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