Respiratory Function Monitor Guidance of Mask Ventilation in the Delivery Room: A Feasibility Study

Objective To investigate whether using a respiratory function monitor (RFM) during mask resuscitation of preterm infants reduces face mask leak and improves tidal volume (V-T). Study design Infants receiving mask resuscitation were randomized to have the display of an RFM (airway pressure, flow, and V-T waves) either visible or masked. Result Twenty-six infants had the RFM visible, and 23 had the RFM masked. The median mask leak was 37% (IQR, 21%-54%) in the visible RFM group and 54% (IQR, 37%-82%) in the masked RFM group (P = .01). Mask repositioning was done in 19 infants (73%) of the visible group and in 6 infants (26%) of the masked group (P = .001). The median expired V-T was similar in the 2 groups. Oxygen was provided to 61% of the visible RFM group and 87% of the RFM masked group (P = .044). Continuous positive airway pressure use was greater in the visible RFM group (73% vs 43%; P = .035). Intubation in the delivery room was done in 21% of the visible group and in 57% of the masked group (P = .035). Conclusion Using an RFM was associated with significantly less mask leak, more mask adjustments, and a lower rate of excessive V-T. (J Pediatr 2012; 160:377-81).