Comparison of two respiratory function monitors for newborn mask ventilation: A randomised crossover study using simulation

Abstract

Objectives

Respiratory function monitors (RFM) provide objective feedback on respiratory parameters during face mask ventilation. While traditional RFMs display detailed waveforms, newer devices use simplified, colour-coded graphics. We aimed to compare three RFM feedback methods against a no-feedback approach, assessing ventilation parameters and user interpretation.

Methods

This simulation-based, crossover randomised study involved healthcare professionals at a tertiary neonatal centre, who received training on two RFMs: a “Coloured graphic” device (Monivent NeoTraining), offering monitor and sensor light feedback, and a “Flow curves” device (Respironics NM3). Participants performed positive pressure ventilation on a manikin across three phases: access to the “Coloured graphic” monitor and sensor light, “Light only”, and access to the “Flow curves” monitor, evaluated against a control phase with no feedback. An interpretation assessment followed. The primary outcome was the median difference in mask leak (%) between the control and the three intervention phases.

Results

Data from 51 participants were analysed. Compared to the control, the median (IQR) mask leak (%) was significantly lower in the “Coloured graphic” phase (11% [7%–26%]; median difference: −13 [95% CI: −26 to −2]). No significant differences were observed in the “Light only” phase (22% [8%–39%]); median difference: −10 [95% CI: −25 to 5]), or “Flow curves” phase (44% [6%–73%]; median difference: 8 [95% CI: −2 to 18]). Although more participants correctly interpreted the “Coloured graphic” feedback, only a minority selected appropriate corrective actions.

Conclusions

Objective feedback from the “Coloured graphic” RFM significantly reduced leak during mask ventilation.