Infant resuscitation therapy

An important aim of infant resuscitation is to provide effective ventilatory support. T-piece resuscitation enables the delivery of a preset, consistent and controlled peak inspiratory pressure (PIP) and positive end-expiratory pressure (PEEP).

Neopuff™ T-piece resuscitator

Delivers controlled, consistent and precise pressures to infants (up to 10 kg) - independent of operator experience.

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Resuscitation masks

Available in five sizes and designed to be soft and pliable, with a transparent surface that allows breath condensate to be observed.

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T-piece resuscitation circuits

Connects to a mask or endotracheal tube and allows positive end-expiratory pressure to be adjusted via the PEEP valve.

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How does T-piece resuscitation work?

The T-piece connects to a face mask or other interface to deliver a flow-regulated, pressure-limited gas supply to the infant, enabling the application of controlled initial inflation breaths.

Consistent and controlled PIP and PEEP delivery help to protect the lungs from injury and establish and maintain functional residual capacity (FRC). FRC is the volume of air that remains in the lungs following a typical expiratory phase. This volume is important for keeping the lungs open post exhalation and for ensuring adequate pulmonary gas exchange.¹

Compared with other types of resuscitators, such as self-inflating bags and flow-inflating bags, T-piece resuscitators provide consistent and controlled pressures independent of operator experience.^2,3

The International Liaison Committee on Resuscitation's (ILCOR) international resuscitation guidelines recommend the use of a T-piece resuscitator when a gas source is available.^4-6

Helps protect the lungs from injury

T-piece resuscitators have been designed to provide consistent and controlled PIP during resuscitation.

PIP is the maximum inspiratory pressure required to improve oxygenation without causing adverse effects. Delivering a controlled PIP is important as uncontrolled PIP that is too high may lead to lung injury, while under-inflating the lungs may not provide adequate gas exchange.

Animal studies have demonstrated that lung injury can occur during resuscitation with just a few large manual inflations.⁷

Fig 1. PEEP: peak end-expiratory pressure.
* Pressure measurements taken from a resuscitation simulator while a self-inflating bag and F&P Healthcare Neopuff were being used by a qualified resuscitator.

T-piece Resuscitation: Neonates and Infants — Clinical Paper Summaries

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te Pas AB et al. Establishing functional residual capacity at birth: the effect of sustained inflation and positive end-expiratory pressure in a preterm rabbit model. Pediatr. Res. 65, 2009, 537. View abstract
Roehr CC et al. Manual ventilation devices in neonatal resuscitation: Tidal volume and positive pressure-provision. Resuscitation 81, 2010, 202-205. View abstract
Roehr CC, Kelm M, Proquitté H and Schmalisch G. Equipment and operator training denote manual ventilation performance in neonatal resuscitation. AM J Perinatol. 27, 2010, 753-758. View abstract
Liley HG, Mildenhall L, Morley P and Resuscitation, on behalf of the ANZC on Australian and New Zealand Committee on Resuscitation Neonatal Resuscitation guidelines 2016. J Paediatr Child Health 53, 2017, 621-627. View abstract
Wyckoff MH et al. Part 13: International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations: Circulation 145(9):e645–e721. 2021. View abstract
Björklund LJ et al. Manual ventilation with a few large breaths at birth compromises the therapeutic effect of subsequent surfactant replacement in immature lambs. Pediatr Res. 42, 1997, 348. View abstract
Wada K, Jobe AH and Ikegami M. Tidal volume effects on surfactant treatment responses with the initiation of ventilation in preterm lambs. J Appl Physiol. 83, 1997, 1054-1061. View abstract

View references

F&P and Neopuff are trademarks of Fisher & Paykel Healthcare Limited. For patent information, see www.fphcare.com/ip