Abstract
BACKGROUND: Although studies suggest that manual volume-controlled ventilation (VCR) may have advantages over manual ventilation provided with a self-inflating resuscitator (SIR), this has not been studied in preterm neonates. In this study, we compared manual VCR to manual SIR. METHODS: Experienced neonatal nurses ventilated 9 intubated preterm neonates in a tertiary care neonatal unit for a period of 5 minutes using the SIR and VCR in random sequence. The VCR was initially set at a tidal volume of 10 mL/kg and adjusted after 30 seconds if deemed necessary for adequate chest expansion. Heart rate, respiratory rate, oxygen saturation, mean airway pres-sure, and end-tidal carbon dioxide were measured at 0, 2.5, 5, and 15 min-utes. Arterial blood samples were obtained at 0 and 5 minutes of ventilation and analyzed for pH, PaCO2, and PaO2. Pressure tracings were inspected to deter-mine highest (PIPmax) and lowest peak inspiratory (PIPmin) pressures. PIP-max -PIP min was used as a measure of pressure variability. RESULTS: Appro-priate ventilation was achieved with both resuscitators. No significant differences (p > 0.05) between baseline and post-trial measurements were seen in any of the measured variables for either device. However, ventilation with the VCR was achieved at significantly lower PIPmax (mean ± SD) (30±9 vs 39 ± 7 torr, 4.0 ± 1.2 vs 5.2 ± 0.93 kPa, p = 0.03) and with less variability in PIP diff (14± 4 vs 24 ± 7 torr, 1.9 ± 0.53 vs 3.2 ± 0.93 kPa, p = 0.001). CONCLUSION: In preterm neonates, manual ventilation using the VCR allows ventilation com-parable to that supplied with the SIR but at lower PIPmax and with less pres-sure variability. [Respir Care 1996;41(12):1083-1089]
Get full access to this article
View all access options for this article.