Colorimetric end-tidal carbon dioxide detectors in the delivery room: strengths and limitations. A case report.
ABSTRACT Clinical assessment and end-tidal carbon dioxide (ETCO2) detectors are used to verify tracheal intubation in newborn infants. A case is presented in which an ETCO2 detector was misleading in determining endotracheal tube (ETT) position but useful in determining the efficacy of ventilation in an extremely preterm infant.
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ABSTRACT: Respiratory support in the delivery room remains challenging. Assessing chest rise is imprecise and mask leak and airway obstruction are common problems. We describe recordings of respiratory signals during delivery room resuscitations and discuss guidance on positive pressure ventilation using respiratory parameters and exhaled carbon dioxide (ECO2 ) during neonatal resuscitations. Conclusion: Observing tidal volume and ECO2 waveforms adds objectivity to clinical assessments. ECO2 could help assess lung aeration and improve lung recruitment immediately after birth This article is protected by copyright. All rights reserved.Acta Paediatrica 04/2014; · 1.97 Impact Factor
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ABSTRACT: Assessment of effective ventilation in neonatal mask ventilation can be difficult. This study aims to determine whether manual ventilation with a T-piece resuscitator containing an inline CO2 detector (either a Pedi-Cap® CO2 detector or a Neo-StatCO2 <Kg® CO2 detector connected to a facemask) facilitates effective positive pressure ventilation compared to no device in a mannequin study. Paediatric and neonatal trainees were randomly assigned to determine which method they began with (no device, Pedi-Cap or a Neo-Stat). The participants used each method for a period of 3 min. They were video-recorded to determine the amount of effective ventilations delivered and the overall percentage efficiency of each method. Efficacy of ventilation was determined by comparing the number of manual ventilations delivered with the number of times chest rise was observed in the video recording. There were 19 paediatric trainees who provided a total of 7,790 ventilations, and 93% were deemed effective. The percentage of effective ventilations with the T-piece resuscitator alone, the PediCap and the NeoStat were 90, 94 and 96%, respectively. The difference was greatest in the first minute (T-piece resuscitator alone 87.5%, PediCap 94%, NeoStat 96%). Two thirds preferred the Neo-Stat. The use of a CO2 detector improves positive pressure ventilation in a mannequin model, especially in the first minute of positive pressure ventilation. The Neo-Stat CO2 detector was the preferred device by the majority of the participants.European Journal of Pediatrics 06/2013; · 1.91 Impact Factor
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ABSTRACT: We present a new device for verifying endotracheal tube (ETT) position that uses specialized sensors intended to distinguish anatomical features of the trachea and esophagus. This device has the potential to increase the safety of resuscitation, surgery, and mechanical ventilation and decrease the morbidity, mortality, and health care costs associated with esophageal intubation and unintended extubation by potentially improving the process and maintenance of endotracheal intubation. The device consists of a tactile sensor connected to the airway occlusion cuff of an ETT. It is intended to detect the presence or absence of tracheal rings immediately upon inflation of the airway occlusion cuff. The initial study detailed here verifies that a prototype device can detect contours similar to tracheal rings in a tracheal model.International Journal of Clinical Monitoring and Computing 09/2013;