A paper by Hinder et al [1] demonstrates that the T-piece device on the GE Panda and Draeger resuscitaires delivers a higher pressure at the start of inflation than is set on the dial. In a low compliance lung model this resulted in increased tidal volume.  

BAPM has since been approached by a centre who has replicated this phenomenon in bench testing (read letter below). The Neopuff device does not generate such a spike. A response from GE, based on their own simulation, indicates that they consider the pressure spike is unlikely to be transmitted to the lungs. In a single case described in the research paper, the pressure spike is demonstrated to be affecting flow and volume during resuscitation in a 750g 28 week gestation baby.

While wishing to draw this issue to your attention for information and local discussion, the BAPM would like to stress that the clinical importance of this pressure spike is presently uncertain and may not be confined to these makes of resuscitaires alone. Members should contact their local representative if they wish to discuss this further.

Professor Ben Stenson requests that units email him with the details of the device used locally and the name of the unit in order that he can investigate this further.

1. Hinder KM et al.T-piece resuscitators: can they provide safe ventilation in a low compliant newborn lung? Arch Dis Child Fetal Neonatal Ed. 2021 Jan;106(1):25-30.

Email Ben Stenson

T-Piece pressure letter
British Association of Perinatal Medicine (BAPM) is registered in England & Wales under charity number 1199712 at 5-11 Theobalds Road, London, WC1X 8SH.
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