Respiratory function monitoring during neonatal resuscitation: a crossover study of high-fidelity simulated bronchopulmonary dysplasia

Purpose We aimed to test the hypothesis that respiratory function monitoring (RFM) during neonatal resuscitation can reduce mask leak and the delivery of inadvertently high tidal volumes. Methods We used a high fidelity neonatal manikin mimicking the lung mechanics of bronchopulmonary dysplasia. Neonatal clinicians provided positive pressure ventilation with a bag-valve and mask while blinded and while unblinded to the RFM, displaying the leak and the tidal volume. Results The median (IQR) inspiratory tidal volume when blinded to the RFM [8.3 (7.1–10.6) ml/kg] was significantly higher compared to when unblinded to the RFM [6.7 (5.8–8.3) ml/kg, p = 0.002]. The expiratory tidal volume when blinded to the RFM [6.5 (5.8–7.8) ml/kg] was significantly higher compared to when unblinded to the RFM [5.7 (5.1–6.9) ml/kg, p = 0.021]. The percentage of leak was not different when blinded to the RFM compared to when unblinded. The peak inflation pressure was not different when blinded to the RFM compared to when unblinded. Conclusion During simulated resuscitation of bronchopulmonary dysplasia, participants were more likely to achieve a tidal volume within the intended range and a higher respiratory rate when they had real-time RFM feedback compared to when such feedback was not available.