Abstract
Background: The effectiveness of positive pressure ventilation (PPV) in the delivery room can be impaired by many factors. This study reviewed recordings of neonatal resuscitations at The Royal Women's Hospital, Melbourne, Australia to assess the prevalence of mask leak and airway obstruction.
Methods and patients: Recordings of infants < 32 weeks gestation born between February 2006 and March 2009 were reviewed. Mask PPV was delivered with a T-piece or self-inflating bag. Airway pressure and gas flow were recorded. A webcam showed the resuscitation. Obstruction was defined as a 75% reduction in expired tidal volume compared to the 10 previous inflations. Face mask leak was defined as a leak ≥ 75% of delivered tidal volume.
Results: Recordings from 53 preterm infants were analysed. A median (IQR) of 76 (53 to 98) inflations were analysed for each infant. Obstruction and leak were identified in 14 (26%) and 27 (51%) respectively. In 8 infants both obstruction and leak were present; in 17 neither occurred. Obstruction occurred at a median (IQR) of 48 (24 - 60) seconds after start of PPV. A median (range) of 22 (3 - 83) consecutive obstructed inflations were delivered during each resuscitation. Face mask leak occurred from the first inflation in 19/27. A median (range) of 10 (3-117) consecutive inflations with a leak ≥ 75% were delivered.
Conclusion: Face mask leak is more common than airway obstruction during neonatal resuscitation. Both may cause a clinically important reduction in the tidal volumes delivered.
Article PDF
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Schmölzer, G., Dawson, J., Kamlin, O. et al. 330 Prevalence of Airway Obstruction and Mask Leak During Face Mask Ventilation of Preterm Infants in the Delivery Room. Pediatr Res 68 (Suppl 1), 170 (2010). https://doi.org/10.1203/00006450-201011001-00330
Issue Date:
DOI: https://doi.org/10.1203/00006450-201011001-00330