Prototype volume-controlled neonatal/infant resuscitator

Abstract

Face mask or bag endotracheal tube manual ventilation of neonates and infants has relied primarily on the use of self-inflating resuscitation devices (SIRs). While SIRs have the advantage of being simple to use and, therefore, require minimal training, recent research has demonstrated significant drawbacks to these devices. These drawbacks have included their large physical size, the tendency of such devices to cause significant hyperventilation, and the extreme variability of pressures necessary to activate the pop-off valve safety feature. This latter problem is especially serious in the infant where large pressure variations may increase the potential for pulmonary barotrauma. In an attempt to minimize the disadvantages of SIRs, we developed a prototype volume-controlled resuscitation device (VCD). We then compared the VCD to the SIRs in a cat model using blinded volunteer health care personnel previously familiar with SIRs only. Ventilation of the cat with the VCD yielded arterial and end-tidal CO2 values more closely resembling the physiologic state at a lower mean airway pressure. The data suggest that a human trial of manual ventilation with the prototype VCD is warranted.