PT - JOURNAL ARTICLE AU - Law, Brenda Hiu Yan AU - Schmölzer, Georg M TI - Volume-targeted mask ventilation during simulated neonatal resuscitation AID - 10.1136/archdischild-2023-325902 DP - 2024 Mar 01 TA - Archives of Disease in Childhood - Fetal and Neonatal Edition PG - 217--220 VI - 109 IP - 2 4099 - http://fn.bmj.com/content/109/2/217.short 4100 - http://fn.bmj.com/content/109/2/217.full SO - Arch Dis Child Fetal Neonatal Ed2024 Mar 01; 109 AB - Objective Mask positive pressure ventilation (PPV) in the delivery room is routinely delivered with set peak inflation pressures. To aid mask PPV, stand-alone respiratory function monitors (RFMs) have been used in the delivery room, while ventilator-based, volume-targeted ventilation (VTV) is routinely used in the neonatal intensive care unit (NICU).Design This is a prospective, randomised, crossover simulation study. Participants were briefly trained to use a neonatal ventilator for volume-targeted mask ventilation (VTV-PPV), then performed mask ventilation on a manikin in a randomised order using VTV-PPV, T-piece PPV or T-piece PPV with RFM visible.Setting In situ in a neonatal resuscitation room within a level 3 NICU.Participants Healthcare professionals (HCPs) trained in neonatal resuscitation with experience as team leaders.Interventions Semiautomated, ventilator-based VTV-PPV using two-hand hold versus manual PPV via a T-piece device (T-piece, RFM masked) versus manual PPV with RFM visible using one-hand hold.Main outcome measures Respiratory characteristics including % mask leak, tidal volume (VT) and peak inflation pressure (PIP).Results Thirty-two HCPs (23 (72%) female and 9 (28%) male) participated. The median mask leak was significantly lower with ‘VTV-PPV’ (11%, IQR 0%–14%) compared with both ‘T-piece, RFM visible’ (82%, IQR 30%–91%) and ‘T-piece, RFM masked’ (81%, IQR 47%–91%) (p<0.0001). The median delivered VT was 4.1 mL/kg (IQR 3.9–4.4) with VTV-PPV compared with 2.1 mL/kg (IQR 1.2–9) with T-piece, RFM visible and 1.8 mL/kg (IQR 1.1–5.8) with T-piece, RFM masked (p=0.0496). PIP was also significantly lower with VTV-PPV.Conclusion During neonatal simulation, VTV-PPV reduced mask leak and allowed for consistent VT delivery compared with T-piece with and without RFM guidance.All data relevant to the study are included in the article or uploaded as supplementary information.