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Real-Time Feedback Device to Improve the Quality of Newborn Ventilation

October 26, 2023

Editor’s Note: Dr. Lucky Ding (she/her/hers) is a resident physician at The University of California-San Francisco Pediatrics Residency Program. She is interested in quality improvement interventions aimed at reducing racial, ethnic, language, and socioeconomic disparities in child health outcomes and access to care. -Rachel Y. Moon, MD, Associate Editor, Digital Media, Pediatrics

Effective bag-mask ventilation is critical to reducing newborn deaths from lack of oxygen during the birthing process. However, even after providers complete their initial newborn resuscitation training, maintaining effective ventilation skills is a documented challenge in both resource-limited and resource-rich settings. A study by Dr. Santorino Data from Mbarara University of Science and Technology in Uganda and colleagues from Uganda and the US, which is being early released this week in Pediatrics, aims to address this challenge (10.1542/peds.2022-060599).

Clinicians in Uganda and the US developed the Augmented Infant Resuscitator (AIR), an add-on device that attaches to standard bag-valve-masks and provides visual feedback on air leaks, blocked airways, harsh breaths, and improper ventilatory rates. The authors then conducted a randomized control study of simulated newborn resuscitations to evaluate whether the real-time digital feedback provided by the AIR, compared to no feedback, helped providers to achieve effective ventilation.

These simulations found that providers using real-time AIR feedback achieved effective ventilation twice as fast and for 50% longer duration than controls. The use of real-time AIR feedback was also associated with significantly more accurate and faster assessment of airway conditions compared to controls.

This study highlights a novel portable add-on device that can objectively assess effective ventilation during training. While this single-day intervention study does not tell us whether real-time feedback during trainings contributes to retention of effective ventilation skills, further studies are underway to demonstrate the long-term effect of real-time feedback.

As a trainee, I would find this type of immediate, visual feedback extremely helpful. I think that AIR would be a valuable training tool for trainees and providers across all healthcare settings, since learning and maintaining effective newborn resuscitation skills is critical to improving newborn health outcomes.

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