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Positive pressure ventilation at neonatal resuscitation: review of equipment and international survey of practice 

Authors: CPF O'Donnell a;  PG Davis a; CJ Morley a
Affiliation:   a Division of Neonatal Services, Royal Women's Hospital Melbourne, Carlton, Victoria, Australia
DOI: 10.1080/08035250410026581
Publication Frequency: 12 issues per year
Published in: journal Acta Paediatrica, Volume 93, Issue 5 May 2004 , pages 583 - 588
Number of References: 51
Formats available: HTML (English) : PDF (English)

The circumstances under which this title is published have changed:

Reason for change: Changed Publisher
Now published by: Blackwell
Date of change: 31 December 2006



Abstract

Background: The equipment used to provide positive pressure ventilation to newborns needing resuscitation at delivery varies between institutions. Devices were reviewed and their use surveyed in a sample of neonatal centres worldwide. Aim: To determine which equipment is used to resuscitate newborns at delivery in a sample of teaching hospitals around the world. Methods: A questionnaire was sent via e-mail to a neonatologist at each of 46 NICUs in 23 countries on five continents, asking which resuscitation equipment they used. If it was not returned, follow-up was by e-mail. Results: Data were obtained from 40 (87%) centres representing 19 countries. Round face masks are used at 34 (85%) centres, anatomically shaped masks are used exclusively at six (15%) and a mixture of types are used at 11 (28%). Straight endotracheal tubes are used exclusively at 36 (90%) centres; shouldered tubes are used infrequently at three of the four centres that have them. The self-inflating bag is the most commonly used manual ventilation device (used at 33 (83%) centres), the Laerdal Infant Resuscitator™ the most popular model. Flow-inflating bags are used at 10 (25%) centres. The Neopuff Infant Resuscitator™ is used at 12 (30%) centres. Varying oxygen concentrations are provided during neonatal resuscitation at half of the centres, while 100% oxygen is routinely used at the other half.

Conclusions: This survey shows considerable variation in practice, reflecting this lack of evidence and consequent uncertainty among clinicians. Comparison of the two most popular manual ventilation devices, the Laerdal Infant Resuscitator and the Neopuff Infant Resuscitator, is urgently required.
Keywords: Infant; newborn; resuscitation; positive pressure respiration; PEEP
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