Assessment of chest rise during mask ventilation of preterm infants in the delivery room
Assessment of chest rise during mask ventilation of preterm infants in the delivery room
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DOI：
10.1016/j.resuscitation.2010.10.012
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发表时间：
2011-02-01
期刊：
影响因子：
6.5
通讯作者：
Davis, Peter G.
中科院分区：
文献类型：
--
作者：
Poulton, David A.;Schmoelzer, Georg M.;Davis, Peter G.
背景资料：目前的新生儿复苏指南建议使用胸壁运动的视觉评估来指导产房正压通气（PPV）期间充气压力的选择。这一评估的准确性尚未得到检验。我们比较了由观察员站在婴儿的头部，在婴儿的一侧与潮气量measurements of tidvolume.Methods：气道压力和呼气潮气量（V-Te）的评估胸部上升进行了测量新生儿复苏期间使用呼吸功能监测。在60 s的PPV后，要求站在婴儿头部（头部视图）和婴儿侧面（侧面视图）的复苏者评估胸部上升并估计V-Te。这些估计值与之前30多岁期间进行的V-Te测量值进行比较。结果：我们研究了20名在30多岁期间接受平均（SD）23（4）次充气的婴儿。一些观察者感觉无法从头部视图（6/20）和侧视图（3/20）评估胸部抬高。头侧观察者倾向于分别低估潮气量3.5 mL和3.3 mL。临床评估和测得的V-Te之间的协议是普遍poor.Conclusion：在面罩通气，复苏者无法准确地评估胸壁运动视觉从头部或侧面的观点。(C)2010爱思唯尔爱尔兰有限公司版权所有。
Background: Current neonatal resuscitation guidelines recommend using visual assessment of chest wall movements to guide the choice of inflating pressure during positive pressure ventilation (PPV) in the delivery room. The accuracy of this assessment has not been tested. We compared the assessment of chest rise made by observers standing at the infants' head and at the infants' side with measurements of tidal volume.Methods: Airway pressures and expiratory tidal volume (V-Te) were measured during neonatal resuscitation using a respiratory function monitor. After 60 s of PPV, resuscitators standing at the infants' head (head view) and at the side of the infant (side view) were asked to assess chest rise and estimate V-Te. These estimates were compared with V-Te measurements taken during the previous 30s.Result: We studied 20 infants who received a mean (SD) of 23 (4) inflations during the 30s. Some observer felt unable to assess chest rise both from the head view (6/20) and from the side view (3/20). Observers from both head and side tended to underestimate tidal volume by 3.5 mL and 3.3 mL respectively. Agreement between clinical assessment and measured V-Te was generally poor.Conclusion: During mask ventilation, resuscitators were unable to accurately assess chest wall movement visually from either head or side view. (C) 2010 Elsevier Ireland Ltd. All rights reserved.