title: Providing PEEP during neonatal resuscitation: which device is best?
abstract: OBJECTIVE
  The study aims to compare three commonly used neonatal resuscitation devices, the Laerdal self-inflating bag with a positive end expiratory pressure (PEEP) valve, a T-piece resuscitator (T-piece) and a flow-inflating bag to provide peak inflation pressure (PIP) and PEEP.
  
  
  METHODS
  Participants were asked to use each device to give positive pressure ventilation to a modified neonatal mannequin via a face mask to achieve 40-60 inflations per minute, aiming for a PIP/PEEP of 30/5 cm H₂O. A manometer was visible to participants with each device. PIP, PEEP, percentage leak at the face mask and expired tidal volume were measured using a hot-wire anemometer. We analysed 20 inflations from each participant for each device.
  
  
  RESULTS
  Fifty participants provided PIP and PEEP with each device. The T-piece was the most accurate and consistent. The flow-inflating bag had the most variation. The leak was lowest with the self-inflating bag and PEEP and highest with the flow-inflating bag, but all had wide variation.
  
  
  CONCLUSIONS
  Each device was able to provide PIP and PEEP when used appropriately. When compared with other resuscitation devices, the T-piece provided the most accurate and consistent PIP and PEEP.
authors: Neonatal Services, The Royal Women's Hospital, Melbourne, Australia.
authors: Jennifer A
authors: JA
authors: Dawson
authors: Angela
authors: A
authors: Gerber
authors: C Omar F
authors: CO
authors: Kamlin
authors: Peter G
authors: PG
authors: Davis
authors: Colin J
authors: CJ
authors: Morley
mesh_terms: D003696:Delivery Rooms; D019544:Equipment Failure Analysis; D006801:Humans; D007231:Infant, Newborn; D011175:Positive-Pressure Respiration / Q000295:instrumentation*; D012151:Resuscitation / Q000295:instrumentation*