Validation of the disposable T-piece resuscitator (Neo-Tee): a bench study.

Arch Dis Child Fetal Neonatal Ed

Department of Neonatology, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.

Published: November 2019

Objective: The Neo-Tee Infant T-piece resuscitator is a disposable T-piece resuscitator. The aim of this bench study was to assess the accuracy of the Neo-Tee using a measurement set-up and settings mimicking clinical practice.

Study Design: Nine Neo-Tee devices were tested using a face mask interface and a manikin. Pressures were set using the built-in manometer and simultaneously measured at the interface. Peak inspiratory pressure (PIP) and positive end-expiratory pressure (PEEP) were studied under static conditions and positive pressure ventilation (PPV), using a wide range of clinically relevant flows and pressures. Pressures were measured without adjusting for a possible offset of PIP and PEEP after switching from static pressures to PPV. In an additional subset of measurements, PIP/PEEP offsets on the Neo-Tee manometer after starting PPV were adjusted.

Results: Under static conditions, setting the PEEP level with the Neo-Tee manometer results in overestimation of the true PEEP applied at the airway opening, with a difference of approximately 1.5 cmHO. When switching to PPV, this difference almost disappears. In contrast to PEEP, PIP levels measured at the airway opening were accurate.Adjusting PIP and PEEP on the built-in manometer after starting PPV was necessary in all measurements, but this did not improve the accuracy of the targeted pressure delivery, especially for PEEP. A gas flow rate of 5 L/min was insufficient to reach commonly used PEEP levels of 5 cmHO.

Conclusion: The Neo-Tee T-piece resuscitator is accurate for delivering a static inflation and PPV, but not for delivering continuous positive airway pressure.

Download full-text PDF

Source
http://dx.doi.org/10.1136/archdischild-2018-315298DOI Listing

Publication Analysis

Top Keywords

t-piece resuscitator
16
disposable t-piece
8
bench study
8
built-in manometer
8
peep
8
static conditions
8
pip peep
8
neo-tee manometer
8
manometer starting
8
starting ppv
8

Similar Publications

Supraglottic airway in neonatal porcine model.

Pediatr Res

January 2025

Centre for the Studies of Asphyxia and Resuscitation, Neonatal Research Unit, Royal Alexandra Hospital, Edmonton, AB, Canada.

Background: Positive pressure ventilation (PPV) in the delivery room is routinely performed using a face mask attached to a ventilation device. In 2023, the Consensus of Science and Treatment Recommendations for neonatal resuscitation stated that a supraglottic airway (SGA) can be used for PPV if resources and training permits. However, there is very limited data on tidal volume (V) delivery using SGAs.

View Article and Find Full Text PDF

Transporting spontaneously ventilating adults with tracheostomies from the operating room (OR) or other anesthetizing locations to the intensive care unit (ICU) or other recovery locations presents significant challenges, as traditional T-pieces may not be readily available. This article describes a novel modification to the Ayre's T-piece, designed to address this gap by using readily available equipment. The modification integrates a 3-mL syringe, a size 7.

View Article and Find Full Text PDF

Background: Continuous positive airway pressure (CPAP) is a recommended first-line therapy for infants with respiratory distress at birth. Resuscitation devices incorporating CPAP delivery can have significantly different imposed resistances affecting airway pressure stability and work of breathing.

Aim: To compare CPAP performance of two resuscitation devices (Neopuff T-piece resuscitator and rPAP) in a neonatal lung model simulating spontaneous breathing effort at birth.

View Article and Find Full Text PDF

Spontaneous breathing trials should be adapted for each patient according to the critical illness. A new individualised approach: the GLOBAL WEAN study.

Intensive Care Med

December 2024

Intensive Care Unit, Department of Anaesthesiology and Critical Care Medicine B (DAR B), Saint-Eloi Hospital, University Teaching Hospital of Montpellier, Montpellier Cedex 5, France.

Article Synopsis
  • The study aimed to determine the most effective spontaneous breathing trial (SBT) methods to evaluate a patient's ability to breathe independently after being extubated, focusing on five critical illnesses.
  • In a multicenter randomized crossover design, 100 adult ICU patients underwent three different 15-minute SBTs, measuring their inspiratory efforts using pressure-time-product (PTPmin) before and after extubation.
  • Results showed that the unassisted SBTs, specifically PSV0PEEP0 and T-piece trials, were the best at simulating the breathing effort experienced after extubation, with varying effectiveness among different patient categories.
View Article and Find Full Text PDF

Purpose Of Review: Guidelines recommend systematic performance of a spontaneous breathing trial (SBT) before extubation in ICUs, the objective being to reduce the risk of reintubation. In theory, a more challenging SBT performed with a T-piece may further reduce the risk of reintubation, whereas a less challenging SBT performed with pressure-support ventilation (PSV) may hasten extubation.

Recent Findings: Recent findings show that a more challenging SBT with a T-piece or for a prolonged duration do not help to reduce the risk of reintubation.

View Article and Find Full Text PDF

Want AI Summaries of new PubMed Abstracts delivered to your In-box?

Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!