TY - JOUR T1 - T-piece resuscitators: can they provide safe ventilation in a low compliant newborn lung? JF - Archives of Disease in Childhood - Fetal and Neonatal Edition JO - Arch Dis Child Fetal Neonatal Ed SP - 25 LP - 30 DO - 10.1136/archdischild-2019-318673 VL - 106 IS - 1 AU - Murray Kenneth Hinder AU - Thomas Drevhammar AU - Snorri Donaldsson AU - Matthew Boustred AU - Matthew Crott AU - Mark Brian Tracy Y1 - 2021/01/01 UR - http://fn.bmj.com/content/106/1/25.abstract N2 - Background T-piece resuscitators (TPRs) are used for primary newborn resuscitation in birthing and emergency rooms worldwide. A recent study has shown spikes in peak inflation pressure (PIP) over set values with two brands of TPRs inbuilt into infant warmer/resuscitation platforms. We aimed to compare delivered ventilation between two TPR drivers with inflation pressure spikes to a standard handheld TPR in a low test lung compliance (Crs), leak-free bench test model.Methods A single operator provided positive pressure ventilation to a low compliance test lung model (Crs 0.2–1 mL/cmH2O) at set PIP of 15, 25, 35 and 40 cmH2O. Two TPR devices with known spikes (Draeger Resuscitaire, GE Panda) were compared with handheld Neopuff (NP). Recommended settings for positive end-expiratory pressure (5 cmH2O), inflation rate of 60/min and gas flow rate 10 L/min were used.Results 2293 inflations were analysed. Draeger and GE TPR drivers delivered higher mean PIP (Panda 18.9–49.5 cmH2O; Draeger 21.2–49.2 cmH2O and NP 14.8–39.9 cmH2O) compared with set PIP and tidal volumes (TVs) compared with the NP (Panda 2.9–7.8 mL; Draeger 3.8–8.1 mL; compared with NP 2.2–6.0 mL), outside the prespecified acceptable range (±10% of set PIP and ±10% TV compared with NP).Conclusion The observed spike in PIP over set values with Draeger and GE Panda systems resulted in significantly higher delivered volumes compared with the NP with identical settings. Manufacturers need to address these differences. The effect on patient outcomes is unknown. ER -