Providing PEEP during neonatal resuscitation: which device is best?

J Paediatr Child Health. 2011 Oct;47(10):698-703. doi: 10.1111/j.1440-1754.2011.02036.x. Epub 2011 Mar 30.


Aim: The study aims to compare three commonly used neonatal resuscitation devices, the Laerdal self-inflating bag with a positive end expiratory pressure (PEEP) valve, a T-piece resuscitator (T-piece) and a flow-inflating bag to provide peak inflation pressure (PIP) and PEEP.

Methods: Participants were asked to use each device to give positive pressure ventilation to a modified neonatal mannequin via a face mask to achieve 40-60 inflations per minute, aiming for a PIP/PEEP of 30/5 cm H₂O. A manometer was visible to participants with each device. PIP, PEEP, percentage leak at the face mask and expired tidal volume were measured using a hot-wire anemometer. We analysed 20 inflations from each participant for each device.

Results: Fifty participants provided PIP and PEEP with each device. The T-piece was the most accurate and consistent. The flow-inflating bag had the most variation. The leak was lowest with the self-inflating bag and PEEP and highest with the flow-inflating bag, but all had wide variation.

Conclusion: Each device was able to provide PIP and PEEP when used appropriately. When compared with other resuscitation devices, the T-piece provided the most accurate and consistent PIP and PEEP.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Delivery Rooms
  • Equipment Failure Analysis
  • Humans
  • Infant, Newborn
  • Positive-Pressure Respiration / instrumentation*
  • Resuscitation / instrumentation*