{
  "abstract": "Background Mask leak is common during newborn resuscitation, impacting delivered ventilation. Less is known about the effect of leak during assisted spontaneous breathing with continuous positive airway pressure (CPAP).Aim Compare CPAP performance in the presence of leak of two T-piece resuscitation devices, with differing design-imposed resistances: high resistance Neopuff and low resistance rPAP.Methods Devices were tested on a term dynamic lung model (compliance 1.0 mL/cmH 2O, tidal volume (VT) 23 mL) at three incremental leak levels and set positive end expiratory pressure (PEEP) 5 cmH2O, 7 cmH2O and 9 cmH2O. Continuous leaks were generated by differing-length tubes open to atmosphere. Measured parameters were mean pressure, fluctuations around set pressure (∆P), VT and leak flow.Results 2437 breaths were analysed (1216 rPAP, 1221 Neopuff). Leak reduced PEEP, with the largest reduction at the highest leak and 9 cmH 2O set PEEP (Neopuff 2.6 cmH2O vs rPAP 7.0 cmH2O). Higher delivered PEEP was associated with higher leak flows (Neopuff 4.4 L/min vs rPAP 8.2 L/min, 9 cmH2O set PEEP). VT reduced with Neopuff compared with rPAP (Neopuff 18 mL vs rPAP 23.2 mL, no leak, 9 cmH2O set PEEP) and was affected by delivered PEEP.Conclusion The delivered support differed between devices in the presence of leaks. rPAP maintained pressures closer to the set PEEP value at all leak levels, and higher leak flows were seen with the maintained distending pressure. Neopuff’s higher resistance led to reductions in VT that were more pronounced at low leak levels.",
  "authors": [
    {
      "affiliations": [
        "Department of Paediatrics and Adolescent Medicine, Medical University of Graz Division of Neonatology, Graz, Austria",
        "UNSW Sydney, Sydney, New South Wales, Australia"
      ],
      "name": "Viktoria Gruber"
    },
    {
      "affiliations": [
        "Biomedical Engineering, The University of Sydney Faculty of Engineering, Sydney, New South Wales, Australia",
        "Neonatal Intensive Care Unit, Westmead Hospital, Westmead, New South Wales, Australia"
      ],
      "name": "Stephanie Morakeas"
    },
    {
      "affiliations": [
        "Neonatal Intensive Care Unit, Westmead Hospital, Westmead, New South Wales, Australia",
        "Westmead Clinical School, The University of Sydney, Sydney, New South Wales, Australia"
      ],
      "name": "Murray Hinder"
    },
    {
      "affiliations": [
        "Women's and Children’s Health, Karolinska Institute, Stockholm, Sweden"
      ],
      "name": "Thomas Drevhammar"
    },
    {
      "affiliations": [
        "Translational Health Research Institute, Western Sydney University, Penrith, New South Wales, Australia"
      ],
      "name": "Mithilesh Dronavalli"
    },
    {
      "affiliations": [
        "Neonatal Intensive Care Unit, Westmead Hospital Women’s & Newborn Health Department, Westmead, New South Wales, Australia",
        "Paediatrics and Child Health, The University of Sydney, Sydney, New South Wales, Australia"
      ],
      "name": "Mark Brian Tracy"
    }
  ],
  "title": "Leak during term neonatal CPAP stabilisation: does resuscitation device design affect delivered PEEP – a bench study",
  "uid": "023ab687-fac5-5615-bf17-c6973c69ee53"
}