新生儿气囊活瓣面罩复苏器的监测设备EvaluationoftheAugmented.PDFVIP

增强婴儿复苏器的评价：新生儿气囊活瓣面罩复苏器的监测设备 Evaluation of the Augmented Infant Resuscitator: A Monitoring Device for Neonatal Bag-Valve-Mask Resuscitation * *† * Bennett, Desmond J. BA ; Itagaki, Taiga MD ; Chenelle, Christopher T. BA ; † *† Bittner, Edward A. MD, PhD ; Kacmarek, Robert M. PhD, RRT Anesthesia Analgesia: 2018 126 947 –955 背景：每年有 600 万新生儿需要气囊活瓣面罩复苏，提供即时反馈有可能提高复 苏质量。增强婴儿复苏器（AIR）是一种实时反馈设备，旨在识别气囊活瓣面罩 复苏期间的泄漏、阻塞，以及不适当的呼吸频率。但是，它的功能尚未进行评估。 方法：将其连接在呼吸机和呼吸机测试仪之间来测量 AIR 的阻力。为了测试设备 在训练和临床应用的可靠性，将其置于气囊或呼吸机与新生儿人体模型和临床肺 模型模拟器之间。肺模型模拟器模拟 3 种尺寸（2,4 和 6 kg）的新生儿。评估泄 漏，阻塞和呼吸频率的变化。 结果：流量为 5L/min 时，AIR 上的压力降低仅 0.38 cm H2O，该设备对呼吸机呼 吸参数几乎没有影响。在人体模型试验期间，它能够检测到所有泄漏和阻塞，100% 及时正确显示警报。在模拟的临床试验中，AIR 在 6 公斤新生儿模型中效果最佳， 其次是 4 公斤模型，最后是 2 公斤模型。在所有 3 种临床模型中，模型显示 73.5％ 的正确指标，当这样做时，耗时 1.6±0.9 秒。 结论：AIR 是可能改善新生儿复苏的一项有希望的创新，但它仅引入阻力边缘值， 并仅在新生儿模型上表现良好，在临床使用前仍需改善其固件。 （马益梅译潘艳、薛张纲校） BACKGROUND Annually, 6 million newborns require bag-valve-mask resuscitation, and providing live feedback has the potential to improve the quality of resuscitation. The Augmented Infant Resuscitator (AIR), a real-time feedback device, has been designed to identify leaks, obstructions, and inappropriate breath rates during bag-valve-mask resuscitation. However, its function has not been evaluated. METHODS The resistance of the AIR was measured by attaching it between a ventilator and a ventilator tester. To test the devices reliability in training and clinical-use settings, it was placed in-line between a ventilation bag or ventilator and a neonatal manikin and a clinical lung model simulator. The lung model simulator simulated neonates of 3 sizes (2, 4, and 6 kg). Leaks, obstructions, and respiratory rate alterations were introduced. RESULTS At a flow of 5 L/min, the pressure drop across the AIR was only 0.38 cm H2O, and the device had almost no eff