6633 Use of a respiratory function monitor in newborn mannikin resuscitation

Objectives Animal and observational human studies report that delivery of excessive tidal volume (VT) at birth is associated with lung and brain injury.¹ ² A respiratory function monitor (RFM) is a potential tool to enhance the appropriateness of positive pressure ventilation (PPV) inflations in the delivery room.³ ⁴ The aim of this study was to assess the impact of using an RFM on neonatal resuscitation performance. Methods A respiratory function monitor device (Monivent Neo100) was used. The device consists of a face mask with an in-built differential pressure pneumotachograph which provides feedback via an integrated bluetooth sensor module. Continuous real-time feedback of volume delivered, leak (%) and inflation rate (breaths per minute) are displayed on a wireless LED monitor. Following a period of education and familiarisation, participants were asked to provide single person mask PPV to a mannikin model. As per the Resuscitation Council (UK) Newborn Life Support algorithm for newborn resuscitation, participants delivered five inflations (30 cm H2O) over 2–3 seconds followed by 30seconds of ventilation six times to a mannikin model with an estimated weight of 2.5kg. Each alternate round the resuscitators were blinded to the Monivent Neo100 interface. Results A total of 2712 inflations from 23 participants were analysed. The level of neonatal resuscitation experience of participants varied from less than one year (n=5), between 1 and 5 years (n=10) and more than 5 years (n=8) of neonatal resuscitation experience. On analysis, there was lower leak (median [IQR]: 14 [5–41]% versus 17 [5–57]; p<0.015) and reduced delivery of excessive tidal volume (median [IQR]: 13.2 [12–16]ml/kg vs 14 [12–20]ml/kg; p <0.001) when participants were unblinded to the results of the Monivent device [table 1]. Participants with less clinical experience (6month-1 year vs 1–5 years vs >5years) achieved lower leak (%) with Monivent usage (median [IQR]: 8 [3–26] versus 14 [5–41] versus 30 [7–66]; p <0.001). Conclusion In conclusion, the use of an RFM was associated with superior performance in simulated mannikin resuscitation. References de Medeiros SM, et al. Respiratory function monitoring to improve the outcomes following neonatal resuscitation: a systematic review and meta-analysis. Arch Dis Child Fetal Neonatal Ed 2022;107(6):589–96. Mian Q, et al. Impact of delivered tidal volume on the occurrence of intraventricular haemorrhage in preterm infants during positive pressure ventilation in the delivery room. Arch Dis Child Fetal Neonatal Ed 2019;104(1):F57-f62. van Vonderen JJ, et al. Cardiorespiratory Monitoring during Neonatal Resuscitation for Direct Feedback and Audit. Front Pediatr 2016;4:38. Milner A, et al. Evaluation of respiratory function monitoring at the resuscitation of prematurely born infants. Eur J Pediatr 2015;174(2):205–8.