Potential hazard of the Neopuff T-piece resuscitator in the absence of flow limitation.

Hdl Handle:
http://hdl.handle.net/10147/206214
Title:
Potential hazard of the Neopuff T-piece resuscitator in the absence of flow limitation.
Authors:
Hawkes, C P; Oni, O A; Dempsey, E M; Ryan, C A
Affiliation:
Department of Neonatology, Cork University Maternity Hospital, Wilton, Cork,, Ireland.
Citation:
Arch Dis Child Fetal Neonatal Ed. 2009 Nov;94(6):F461-3. Epub 2009 Apr 8.
Journal:
Archives of disease in childhood. Fetal and neonatal edition
Issue Date:
31-Jan-2012
URI:
http://hdl.handle.net/10147/206214
DOI:
10.1136/adc.2008.155945
PubMed ID:
19357121
Abstract:
OBJECTIVE: (1) To assess peak inspiratory pressure (PIP), positive end expiratory pressure (PEEP) and maximum pressure relief (P(max)) at different rates of gas flow, when the Neopuff had been set to function at 5 l/min. (2) To assess maximum PIP and PEEP at a flow rate of 10 l/min with a simulated air leak of 50%. DESIGN: 5 Neopuffs were set to a PIP of 20, PEEP of 5 and P(max) of 30 cm H(2)O at a gas flow of 5 l/min. PIP, PEEP and P(max) were recorded at flow rates of 10, 15 l/min and maximum flow. Maximum achievable pressures at 10 l/min gas flow, with a 50% air leak, were measured. RESULTS: At gas flow of 15 l/min, mean PEEP increased to 20 (95% CI 20 to 21), PIP to 28 (95% CI 28 to 29) and the P(max) to 40 cm H(2)O (95% CI 38 to 42). At maximum flow (85 l/min) a PEEP of 71 (95% CI 51 to 91) and PIP of 92 cm H(2)O (95% CI 69 to 115) were generated. At 10 l/min flow, with an air leak of 50%, the maximum PEEP and PIP were 21 (95% CI 19 to 23) and 69 cm H(2)O (95% CI 66 to 71). CONCLUSIONS: The maximum pressure relief valve is overridden by increasing the rate of gas flow and potentially harmful PIP and PEEP can be generated. Even in the presence of a 50% gas leak, more than adequate pressures can be provided at 10 l/min gas flow. We recommend the limitation of gas flow to a rate of 10 l/min as an added safety mechanism for this device.
Language:
eng
MeSH:
Equipment Design; Equipment Safety/methods; Humans; Infant; Manometry; Positive-Pressure Respiration/adverse effects/instrumentation/methods; Respiration, Artificial/adverse effects/*instrumentation/methods
ISSN:
1468-2052 (Electronic); 1359-2998 (Linking)

Full metadata record

DC FieldValue Language
dc.contributor.authorHawkes, C Pen_GB
dc.contributor.authorOni, O Aen_GB
dc.contributor.authorDempsey, E Men_GB
dc.contributor.authorRyan, C Aen_GB
dc.date.accessioned2012-01-31T16:43:10Z-
dc.date.available2012-01-31T16:43:10Z-
dc.date.issued2012-01-31T16:43:10Z-
dc.identifier.citationArch Dis Child Fetal Neonatal Ed. 2009 Nov;94(6):F461-3. Epub 2009 Apr 8.en_GB
dc.identifier.issn1468-2052 (Electronic)en_GB
dc.identifier.issn1359-2998 (Linking)en_GB
dc.identifier.pmid19357121en_GB
dc.identifier.doi10.1136/adc.2008.155945en_GB
dc.identifier.urihttp://hdl.handle.net/10147/206214-
dc.description.abstractOBJECTIVE: (1) To assess peak inspiratory pressure (PIP), positive end expiratory pressure (PEEP) and maximum pressure relief (P(max)) at different rates of gas flow, when the Neopuff had been set to function at 5 l/min. (2) To assess maximum PIP and PEEP at a flow rate of 10 l/min with a simulated air leak of 50%. DESIGN: 5 Neopuffs were set to a PIP of 20, PEEP of 5 and P(max) of 30 cm H(2)O at a gas flow of 5 l/min. PIP, PEEP and P(max) were recorded at flow rates of 10, 15 l/min and maximum flow. Maximum achievable pressures at 10 l/min gas flow, with a 50% air leak, were measured. RESULTS: At gas flow of 15 l/min, mean PEEP increased to 20 (95% CI 20 to 21), PIP to 28 (95% CI 28 to 29) and the P(max) to 40 cm H(2)O (95% CI 38 to 42). At maximum flow (85 l/min) a PEEP of 71 (95% CI 51 to 91) and PIP of 92 cm H(2)O (95% CI 69 to 115) were generated. At 10 l/min flow, with an air leak of 50%, the maximum PEEP and PIP were 21 (95% CI 19 to 23) and 69 cm H(2)O (95% CI 66 to 71). CONCLUSIONS: The maximum pressure relief valve is overridden by increasing the rate of gas flow and potentially harmful PIP and PEEP can be generated. Even in the presence of a 50% gas leak, more than adequate pressures can be provided at 10 l/min gas flow. We recommend the limitation of gas flow to a rate of 10 l/min as an added safety mechanism for this device.en_GB
dc.language.isoengen_GB
dc.subject.meshEquipment Designen_GB
dc.subject.meshEquipment Safety/methodsen_GB
dc.subject.meshHumansen_GB
dc.subject.meshInfanten_GB
dc.subject.meshManometryen_GB
dc.subject.meshPositive-Pressure Respiration/adverse effects/instrumentation/methodsen_GB
dc.subject.meshRespiration, Artificial/adverse effects/*instrumentation/methodsen_GB
dc.titlePotential hazard of the Neopuff T-piece resuscitator in the absence of flow limitation.en_GB
dc.contributor.departmentDepartment of Neonatology, Cork University Maternity Hospital, Wilton, Cork,, Ireland.en_GB
dc.identifier.journalArchives of disease in childhood. Fetal and neonatal editionen_GB
dc.description.provinceMunster-

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