Abstract
Background: Supplemental oxygen is often given to infants in the delivery room. Clinicians adjust oxygen concentration (FiO2) in order to prevent hypoxia and hyperoxia. Using an animal model, we aimed to measure the delivered FiO2 when using a T-piece and a self-inflating bag (SIB) and oxygen via a blender.
Method: Preterm lambs were ventilated using a T-piece (gas flow 8L/min, PIP 30cm Head2O, PEEP 5cm Head2O) or a SIB (gas flow 8 L/min, targeted PIP 30cm Head2O, no PEEP) at a rate of 60 inflations/min. FiO2 was set at the blender and measured close to the ETT. Delivered oxygen concentration was measured for both devices using various combinations of incremental changes (every 15s, 30s, 60s and increments of 10%, 20% or air-to-100%).
Results: 234 combinations were analysed. Delivered FiO2 was always less than that set at the blender when increasing FiO2. The T-piece took significantly less time than the SIB to deliver an increase of at least 80% of each desired change: mean(SD) 12(5) versus 19(4) seconds (P< 0.001). When decreasing FiO2, the set level was never reached using the SIB if changes were made every 15 seconds. It took a mean (SD) of 38 (8) seconds to reach 21% when oxygen was changed straight from 100% to 21%.
Conclusions: There are important differences between set and delivered FiO2 when using a blender. Clinicians should be aware of the considerable time delay between making changes on a blender and the infant receiving the desired oxygen concentrations.
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Thio, M., Klingenberg, C., Schmölzer, G. et al. Changing Oxygen Concentration in the Delivery Room: You May Not Get What You Expect. Pediatr Res 70 (Suppl 5), 559 (2011). https://doi.org/10.1038/pr.2011.784
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DOI: https://doi.org/10.1038/pr.2011.784