To investigate the compressive force applied to the head during face mask ventilation in the delivery room and to determine whether this force has influence on cerebral oxygenation.
ID
Source
Brief title
Condition
- Other condition
Synonym
Health condition
hersendoorbloeding
Research involving
Sponsors and support
Intervention
Outcome measures
Primary outcome
Correlation of the amount of force (grams) on the head during neonatal
resuscitation with the regional oxygen saturation (%) of the brain.
Secondary outcome
- Correlation of regional oxygen saturation (%) measured at the right arm with
regional oxygen saturation of the brain measured at the forehead (%).
- Correlation of major disabilities during admission at the NICU (death,
intra-ventricular hemorrhage, periventricular leucomalacia etc.) with the
amount of force (grams).
Background summary
An appropriate mask technique is essential for establishing effective
ventilation.(1) Leak between mask and face is common, even for experienced
operators, and it reduces the efficacy of resuscitation.(2-4) Also airway
obstruction can influence mask ventilation immediately after birth, (3;5)
especially in very low birth weight infants as they have a relatively large
tongue and small mandibles.(5) While investigating mask ventilation techniques
using manikins, we observed that when the resuscitator was notified of mask
leak, airway obstruction often accompanied the corrective action.(2) Possibly
by applying to much pressure on the head with the face mask.(2) When we
quantified force applied to a manikin*s head during simulated mask ventilation
we observed that using a T-piece resuscitator mean (SD) forces of 2028 (909) g
was exerted on the head. (6) This equals pressured of 164 (73) mm Hg.(6) Also
when the participant was asked to minimize the mask leak in a second attempt
similar forces were measured.(6) We speculate that these forces can have
significant physiological impact on the blood circulation in the skull. Indeed,
as the systemic arterial pressures are only 50*60 mm Hg (at best), (6) we would
expect cerebral capillary blood flow to effectively cease in regions exposed to
the greatest force and cerebral oxygenation to drop. If the pressures persist,
this may cause hypoxic/ischaemic injury as well as increasing the risk
hyperperfusion injury following the release of force.
So far force was only measured during simulated resuscitation, but to
investigate the force on the head and its effect on cerebral oxygenation an
observational study during neonatal resuscitation would be needed.
Study objective
To investigate the compressive force applied to the head during face mask
ventilation in the delivery room and to determine whether this force has
influence on cerebral oxygenation.
Study design
Observational study
Study burden and risks
All measurements are strictly observational and will not in any way influence
the way the infant is treated. Therefore there are no risks.
Albinusdreef 2
Leiden 2300 RC
NL
Albinusdreef 2
Leiden 2300 RC
NL
Listed location countries
Age
Inclusion criteria
Preterm infants requiring resuscitation will be included in this study
Exclusion criteria
Preterm infants with malformation of the head, face or the upper respiratory tract.
Design
Recruitment
metc-ldd@lumc.nl
Followed up by the following (possibly more current) registration
No registrations found.
Other (possibly less up-to-date) registrations in this register
No registrations found.
In other registers
| Register | ID |
|---|---|
| CCMO | NL43081.058.13 |