Limits...
Accuracy of currently available neonatal respiratory function monitors for neonatal resuscitation.

Verbeek C, van Zanten HA, van Vonderen JJ, Kitchen MJ, Hooper SB, Te Pas AB - Eur. J. Pediatr. (2016)

Bottom Line: Changing from cold dry to heated humidified air increased the volume difference using the Florian (cold dry air, heated humidified air (+5.2 (1.2)%, +12.2 (0.9)%) but not NLB Neo-RSD (+2.0(1.6)%, +3.4(2.8)%) and NICO (-2.3 % (0.8), +0.1 (0.6)%).Similarly, when using heated humidified air, increasing oxygen enlarged increased the volume difference using the Florian (oxygen 21 %, 100 %: +12.2(1.0)%, +19.8(1.1)%), but not NLB Neo-RSD (+0.2(1.9)%, +1.1(2.8)%) and NICO (-5.6(0.9)%, -3.7(0.9)%).Clinically relevant changes occurred when changing both gas conditions (Florian +25.7(1.7)%; NLB Neo-RSD +3.8(2.4)%; NICO -5.7(1.4)%).

View Article: PubMed Central - PubMed

Affiliation: Division of Neonatology, postzone J6-S, Leiden University Medical Centre, Albinusdreef 2, 2333ZA, Leiden, The Netherlands.

ABSTRACT

Unlabelled: This study aimed to test the accuracy in volume measurements of three available respiratory function monitors (RFMs) for neonatal resuscitation and the effect of changing gas conditions. The Florian, New Life Box Neo-RSD (NLB Neo-RSD) and NICO RFM were tested on accuracy with volumes of 10 and 20 mL and on changes in volume measurements under changing gas conditions (oxygen level 21-100 % and from cold dry air (24 ± 2 °C) to heated humidified air (37 °C). Volume differences >10 % were considered clinically relevant. We found that the mean (SD) volume difference was clinically acceptable for all devices (10, 20 mL): Florian (+8.4 (1.2)%, +8.4 (0.5)%); NLB Neo-RSD (+5.8 (1.1)%, +4.3 (1.4)%); and NICO (-8.2 (0.9)%, -8.7 (0.8)%). Changing from cold dry to heated humidified air increased the volume difference using the Florian (cold dry air, heated humidified air (+5.2 (1.2)%, +12.2 (0.9)%) but not NLB Neo-RSD (+2.0(1.6)%, +3.4(2.8)%) and NICO (-2.3 % (0.8), +0.1 (0.6)%). Similarly, when using heated humidified air, increasing oxygen enlarged increased the volume difference using the Florian (oxygen 21 %, 100 %: +12.2(1.0)%, +19.8(1.1)%), but not NLB Neo-RSD (+0.2(1.9)%, +1.1(2.8)%) and NICO (-5.6(0.9)%, -3.7(0.9)%). Clinically relevant changes occurred when changing both gas conditions (Florian +25.7(1.7)%; NLB Neo-RSD +3.8(2.4)%; NICO -5.7(1.4)%).

Conclusion: The available RFMs demonstrated clinically acceptable deviations in volume measurements, except for the Florian when changing gas conditions.

What is known: •Respiratory function monitors (RFMs) are increasingly used for volume measurements during respiratory support of infants at birth. •During respiratory support at birth, gas conditions can change quickly, which can influence the volume measurements. What is new: •The available RFMs have clinically acceptable deviations when measuring the accuracy of volume measurements. •The RFM using a hot wire anemometer demonstrated clinically relevant deviations in volume measurements when changing the gas conditions. These deviations have to be taken into account when interpreting the volumes directly at birth.

No MeSH data available.


Related in: MedlinePlus

The experimental set-up to test the deviation under different gas conditions
© Copyright Policy - OpenAccess
Related In: Results  -  Collection


getmorefigures.php?uid=PMC4930469&req=5

Fig2: The experimental set-up to test the deviation under different gas conditions

Mentions: Positive pressure ventilation (50/min) was given using a T-piece ventilator (Neopuff Infant Resuscitator, Fisher & Paykel, Auckland, New Zealand) using a peak inspiratory pressure (PIP) of 25 cm H2O and a positive end-expiratory pressure (PEEP) of 5 cm H2O [5], and pressures were not changed during the experiment. The T-piece of the ventilator was attached to a 50 mL test lung (Dräger, Lübeck, Germany, compliance of 0.66 mL/mbar) with the three flow probes placed serial between the T-piece and the test lung (Fig. 2). To test the effect of increasing oxygen on the flow measurements, baseline measurements were performed with air and then oxygen was increased to 100 %. To test the effect of changing gas conditions, baseline measurements were performed with cold dry air (24 ± 2 °C) and then humidified heated air (37 °C) was given using a humidifier (MR 850, Fisher & Paykel, Auckland, New Zealand). The system (Fig. 2) was tested to be leak free before the start of each experiment. Four different gas compositions were then tested and compared: 21 % O2 dry cold air, 21 % O2 humidified heated air, 100 % O2 dry cold air, and 100 % O2 humidified heated air. The humidifier was placed between the Neopuff and T-piece, and the distance of the tubing to the T-piece was 1.3 m (Fig. 2). During the experiment, the changing in gas condition was repeated 10 times for each flow probe, and two different flow probes were used for each device. Inspired tidal volume was taken as the outcome measurement.Fig. 2


Accuracy of currently available neonatal respiratory function monitors for neonatal resuscitation.

Verbeek C, van Zanten HA, van Vonderen JJ, Kitchen MJ, Hooper SB, Te Pas AB - Eur. J. Pediatr. (2016)

The experimental set-up to test the deviation under different gas conditions
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4930469&req=5

Fig2: The experimental set-up to test the deviation under different gas conditions
Mentions: Positive pressure ventilation (50/min) was given using a T-piece ventilator (Neopuff Infant Resuscitator, Fisher & Paykel, Auckland, New Zealand) using a peak inspiratory pressure (PIP) of 25 cm H2O and a positive end-expiratory pressure (PEEP) of 5 cm H2O [5], and pressures were not changed during the experiment. The T-piece of the ventilator was attached to a 50 mL test lung (Dräger, Lübeck, Germany, compliance of 0.66 mL/mbar) with the three flow probes placed serial between the T-piece and the test lung (Fig. 2). To test the effect of increasing oxygen on the flow measurements, baseline measurements were performed with air and then oxygen was increased to 100 %. To test the effect of changing gas conditions, baseline measurements were performed with cold dry air (24 ± 2 °C) and then humidified heated air (37 °C) was given using a humidifier (MR 850, Fisher & Paykel, Auckland, New Zealand). The system (Fig. 2) was tested to be leak free before the start of each experiment. Four different gas compositions were then tested and compared: 21 % O2 dry cold air, 21 % O2 humidified heated air, 100 % O2 dry cold air, and 100 % O2 humidified heated air. The humidifier was placed between the Neopuff and T-piece, and the distance of the tubing to the T-piece was 1.3 m (Fig. 2). During the experiment, the changing in gas condition was repeated 10 times for each flow probe, and two different flow probes were used for each device. Inspired tidal volume was taken as the outcome measurement.Fig. 2

Bottom Line: Changing from cold dry to heated humidified air increased the volume difference using the Florian (cold dry air, heated humidified air (+5.2 (1.2)%, +12.2 (0.9)%) but not NLB Neo-RSD (+2.0(1.6)%, +3.4(2.8)%) and NICO (-2.3 % (0.8), +0.1 (0.6)%).Similarly, when using heated humidified air, increasing oxygen enlarged increased the volume difference using the Florian (oxygen 21 %, 100 %: +12.2(1.0)%, +19.8(1.1)%), but not NLB Neo-RSD (+0.2(1.9)%, +1.1(2.8)%) and NICO (-5.6(0.9)%, -3.7(0.9)%).Clinically relevant changes occurred when changing both gas conditions (Florian +25.7(1.7)%; NLB Neo-RSD +3.8(2.4)%; NICO -5.7(1.4)%).

View Article: PubMed Central - PubMed

Affiliation: Division of Neonatology, postzone J6-S, Leiden University Medical Centre, Albinusdreef 2, 2333ZA, Leiden, The Netherlands.

ABSTRACT

Unlabelled: This study aimed to test the accuracy in volume measurements of three available respiratory function monitors (RFMs) for neonatal resuscitation and the effect of changing gas conditions. The Florian, New Life Box Neo-RSD (NLB Neo-RSD) and NICO RFM were tested on accuracy with volumes of 10 and 20 mL and on changes in volume measurements under changing gas conditions (oxygen level 21-100 % and from cold dry air (24 ± 2 °C) to heated humidified air (37 °C). Volume differences >10 % were considered clinically relevant. We found that the mean (SD) volume difference was clinically acceptable for all devices (10, 20 mL): Florian (+8.4 (1.2)%, +8.4 (0.5)%); NLB Neo-RSD (+5.8 (1.1)%, +4.3 (1.4)%); and NICO (-8.2 (0.9)%, -8.7 (0.8)%). Changing from cold dry to heated humidified air increased the volume difference using the Florian (cold dry air, heated humidified air (+5.2 (1.2)%, +12.2 (0.9)%) but not NLB Neo-RSD (+2.0(1.6)%, +3.4(2.8)%) and NICO (-2.3 % (0.8), +0.1 (0.6)%). Similarly, when using heated humidified air, increasing oxygen enlarged increased the volume difference using the Florian (oxygen 21 %, 100 %: +12.2(1.0)%, +19.8(1.1)%), but not NLB Neo-RSD (+0.2(1.9)%, +1.1(2.8)%) and NICO (-5.6(0.9)%, -3.7(0.9)%). Clinically relevant changes occurred when changing both gas conditions (Florian +25.7(1.7)%; NLB Neo-RSD +3.8(2.4)%; NICO -5.7(1.4)%).

Conclusion: The available RFMs demonstrated clinically acceptable deviations in volume measurements, except for the Florian when changing gas conditions.

What is known: •Respiratory function monitors (RFMs) are increasingly used for volume measurements during respiratory support of infants at birth. •During respiratory support at birth, gas conditions can change quickly, which can influence the volume measurements. What is new: •The available RFMs have clinically acceptable deviations when measuring the accuracy of volume measurements. •The RFM using a hot wire anemometer demonstrated clinically relevant deviations in volume measurements when changing the gas conditions. These deviations have to be taken into account when interpreting the volumes directly at birth.

No MeSH data available.


Related in: MedlinePlus