Tidal volume measurements in the delivery room in preterm infants requiring positive pressure ventilation via endotracheal tube-feasibility study

OBJECTIVE: Current delivery room (DR) resuscitation utilizes pressure-limited devices without tidal volume (TV) measurements. Clinicians use chest expansion as a surrogate, which is a poor indicator of TV. TV in early life can be highly variable due to rapidly changing lung compliance. Our objectives were to assess feasibility of measuring TV in DR, and to report the generated TV in intubated patients. STUDY DESIGN: Prospective, observational, feasibility study in infants <32 weeks GA and intubated in DR. TV was measured using a respiratory function monitor. RESULT: Ten infants with mean GA 23.9(±1.5) weeks and mean BW 618.5(±155) gram were included. Total of 178 min (mean 17.8 min/patient) with 8175 individual breaths (mean 817.5 breaths/patient) were analyzed. Goal TV of 4–6 ml/kg was provided 23.5% of times with high TV (>6 ml/kg) provided 47.7% of times. CONCLUSION: TV measurement in DR is feasible. It is associated with high intra and inter-patient variability.