Resuscitators' opinions on using a respiratory function monitor during neonatal resuscitation

Abstract

Aim The aim of this study was to assess the resuscitators' opinions of the usefulness and clinical value of using a respiratory function monitor (RFM) when resuscitating extremely preterm infants with positive pressure ventilation. Methods The link to an online survey was sent to 106 resuscitators from six countries who were involved in a multicentre trial that compared the percentage of inflations within a predefined target range with and without the RFM. The resuscitators were asked to assess the usefulness and clinical value of the RFM. The survey was online for 4 months after the trial ended in May 2019. Results The survey was completed by 74 (70%) resuscitators of which 99% considered the RFM to be helpful during neonatal resuscitation and 92% indicated that it influenced their decision‐making. The majority (76%) indicated that using the RFM improved their practice and made resuscitation more effective, even when the RFM was not available. Inadequate training was the key issue that limited the effectiveness of the RFM: 45% felt insufficiently trained, and 78% felt more training in using and interpreting the RFM would have been beneficial. Conclusion Resuscitators considered the RFM to be helpful to guide neonatal resuscitation, but sufficient training was required to achieve the maximum benefit.

Newborn face mask ventilation training using a standardised intervention and respiratory function monitor: a before and after manikin study

“…To date, the visual feedback from RFMs has required considerable instruction, time and experience to interpret, as highlighted by incorrect management strategies with inexperienced users 12. Kuypers et al 11 emphasised the need for improved training on RFM interpretation after surveying resuscitators involved in the MONitoR trial,15 suggesting that a simpler visual interface may facilitate interpretation, a sentiment echoed by Schilleman et al 17. In response to this, we chose an RFM with a user-friendly interface.…”

“…To date, the visual feedback from RFMs has required considerable instruction, time and experience to interpret, as highlighted by incorrect management strategies with inexperienced users. 12 Kuypers et al 11 emphasised the need for improved training on RFM interpretation after surveying resuscitators involved in the MONitoR trial, 15 suggesting that a simpler visual interface may facilitate interpretation, a sentiment echoed by Schilleman et al 17 In response to this, we chose an RFM with a user-friendly interface. The simplicity of the Monivent's colour-coded visual display, which adopts a traffic light system to depict Vt e , requires minimal training to interpret, as demonstrated by the short (approximately 3 min) training section on monitor interpretation.…”

“…There are, however, limitations to using RFMs in training. Challenges interpreting the feedback from monitors have been reported, 11 which may lead to incorrect management. 12 Furthermore, there is a paucity of validated corrective strategies for use during training to address ineffective ventilations.…”

Introducing a novel respiratory function monitor for neonatal resuscitation training

“…Kuyper et al surveyed clinicians using the New Life Box Neo-RSD RFM in a large multicentre trial in preterm infants 24 , 25 . They reported a similarly high level of satisfaction with the RFM: 99% of clinicians reported that the RFM was helpful during resuscitations; 92% reported that it influenced their decision making.…”

The Critical Role of Technologies in Neonatal Care

“…There are now several respiratory function monitoring (RFM) devices available to support ventilation and guide tidal volume delivery. RFM has been shown to reduce mask leak [44][45][46][47], improve tidal volume and positive inspiratory pressure delivery [47][48][49], and is considered by clinicians to be a helpful tool when sufficient training is provided [50,51]. A recent systematic review and meta-analysis identified three RCTs including a total of 442 patients which compared RFM and clinical assessment versus clinical assessment alone [52].…”