新生儿面罩通气时两种呼吸功能监护仪的比较：模拟随机交叉研究

IF 2.1 Q3 CRITICAL CARE MEDICINE

Resuscitation plus Pub Date : 2025-03-20 DOI:10.1016/j.resplu.2025.100937

C.M. Ní Chathasaigh , A.E. Curley , E. O Currain

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引用次数: 0

摘要

目的呼吸功能监测仪（RFM）对面罩通气期间的呼吸参数提供客观反馈。传统的rfm显示详细的波形，而较新的设备使用简化的彩色编码图形。我们的目的是比较三种RFM反馈方法和无反馈方法，评估通风参数和用户解释。方法：这项基于模拟的交叉随机研究纳入了一家三年级新生儿中心的医疗保健专业人员，他们接受了两种rfm的培训：一种是“彩色图形”设备（Monivent NeoTraining），提供监视器和传感器光反馈，另一种是“流量曲线”设备（呼吸科NM3）。参与者在三个阶段对人体模型进行正压通气：访问“彩色图形”监视器和传感器光，“仅光”，以及访问“流量曲线”监视器，根据没有反馈的控制阶段进行评估。随后进行口译评估。主要结果是对照组和三个干预阶段之间面罩泄漏（%）的中位数差异。结果分析了51名参与者的数据。与对照组相比，在“彩色图像”阶段，中位（IQR）掩膜泄漏（%）显著降低(11% [7%-26%]；中位差：−13 [95% CI:−26至−2])。在“仅光”期未观察到显著差异（22% [8%-39%]）；中位差：−10 [95% CI:−25 ~ 5])，或“流动曲线”阶段(44% [6% ~ 73%]；中位数差异：8 [95% CI:−2至18])。虽然更多的参与者正确地解释了“彩色图形”反馈，但只有少数人选择了适当的纠正措施。结论“彩色图形”RFM的客观反馈可显著减少面罩通气时的泄漏。

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

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.