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Assessment of tidal volume and gas leak during mask ventilation of preterm infants in the delivery room
  1. Georg M Schmölzer1,2,3,4,
  2. Omar C O F Kamlin1,
  3. Colm P F O'Donnell5,
  4. Jennifer A Dawson1,3,6,
  5. Colin J Morley1,3,
  6. Peter G Davis1,3,6
  1. 1Neonatal Services, The Royal Women's Hospital, Melbourne, Australia
  2. 2Department of Paediatrics, Division of Neonatology, Medical University, Graz, Austria
  3. 3Murdoch Children Research Institute, Melbourne, Australia
  4. 4The Ritchie Center, Monash Institute of Medical Research, Melbourne, Australia
  5. 5The National Maternity Hospital, Dublin, Ireland
  6. 6Department of Obstetrics & Gynaecology, The University of Melbourne, Parkville, Australia
  1. Correspondence to Dr Georg M Schmölzer, Department of Newborn Research, The Royal Women's Hospital, 20 Flemington Road, Parkville 3054, Victoria, Australia; georg.schmoelzer{at}


Aim The aim was to compare resuscitators' estimates of tidal volume (VT) and face mask leak with measured values during positive pressure ventilation (PPV) of newborn infants in the delivery room.

Patients and methods The authors measured inflating pressures and VT delivered using a respiratory function monitor, and calculated face mask leak. After 60 s of PPV, resuscitators were asked to estimate VT and face mask leak. These estimates were compared with measurements taken during the previous 30 s.

Results The authors studied 20 infants who received a mean (SD) of 21 (6) inflations during the 30 s. The median (IQR) expired tidal volume (VTe) delivered was 8.7 ml/kg (5.3–11.3). VTe varied widely during each resuscitation and between resuscitators. Five resuscitators could not estimate VTe, one overestimated and 14 underestimated their median delivered VTe. The median (IQR) face mask leak was 29% (16–63%). Leak also varied widely during each resuscitation and between resuscitators. One resuscitator could not estimate mask leak, four overestimated leak and 15 underestimated leak.

Conclusion During face mask ventilation in the delivery room, VT and face mask leak were large and variable. The resuscitators were unable to accurately assess their face mask leak or delivered VT.

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  • Funding GMS and JAD are supported in part by a Royal Women's Hospital Postgraduate Research Degree Scholarship. GSM is supported in part by a Monash International Postgraduate Research Scholarship. PGD is supported in part by an Australian National Health and Medical Research Council Practitioner Fellowship. This study was supported by Australian National Health and Medical Research Council Program Grant No. 384100.

  • Competing interests None.

  • Ethics approval This study was conducted with the approval of The Royal Women's Hospital Research and Ethics Committees, Melbourne, Australia.

  • Provenance and peer review Not commissioned; externally peer reviewed.