Abstract
Until recently commercially available manual resuscitators were not equipped with PEEP function. A recent development of a manual resuscitator with a PEEP valve attachement (Puritan Bennet and Ambu) offers more physiologic ventilation in surfactant deficient preterm infants. 19 RDS infants (m GA 30 wks, m BW 1279 gms) were studied to see their response to manual ventilation with and without PEEP. A Litton transcutaneous monitor was used to record tcPO2 fluctuation during study. Procedures:1. Remove patient from respirator, 2. Ventilate manually with no PEEP for 3 min., 3. Attach PEEP valve, ventilate for 3 more minutes (PEEP set at 6 cm H2O), 4. Place infant back on respirator. Throughout the procedures patient were kept on the same FiO2, PIP and RR, therefore the only variable was the presence and absence of PEEP. Nine infants were pavulonized, ten were not. Every patient was studied twice, once with PMR-2 and once with Ambu resuscitator.There was significant decrease in tcPO2(-14.1 torr) after manual ventilation without PEEP in all patients. (p<0.02) Three subsequent minutes of manual ventilation with PEEP enabled all patients to regain their PO2 to approximately baseline level. Manual ventilation with no PEEP may be harmful to surfactant deficient infants.
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