While most babies born at term manage transition without significant medical intervention, about 10% may require assistance to begin breathing at birth and less than 1% need advanced neonatal resuscitation interventions.1-4 T-piece resuscitators are typically gas powered and capable of delivering a preset, consistent and controlled peak inspiratory pressure (PIP) and positive end-expiratory pressure (PEEP).
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. At birth, the lungs of preterm infants are uniquely susceptible to injury because they are structurally immature, surfactant deficient, fluid filled, and unsupported by a stiff chest wall. Animal studies have demonstrated that lung injury can occur during resuscitation with just a few large manual inflations.11,12 In immature animals, ventilation at birth with high tidal volumes associated with the generation of high PIP for a few minutes can cause lung injury, impaired gas exchange and reduced lung compliance.13
T-piece resuscitators deliver consistent and controlled PEEP, the residual pressure maintained at the end of expiration. Research suggests adequate levels of PEEP may help to establish and maintain FRC during transition at birth.14 Resuscitation guidelines recommend delivering PEEP whenever positive pressure ventilation is required in the delivery room.15 On a T-piece resuscitator, PEEP can be set to the desired pressure and tested before use on a patient. Research has shown that providing PEEP early during ventilation improves the response to surfactant, and may also reduce delivery room intubation rates and the incidence of lung injury.16-18
Newborn infants are exposed to heat loss immediately following birth. A meta-analysis found that the use of heated and humidified T-piece resuscitation in the delivery room resulted in significantly more infants with normothermia on neonatal intensive care unit (NICU) admission, compared with the use of cold, dry gas.19 Normothermia is defined as a rectal temperature between 36.5 °C and 37.5 °C. The use of heated gas during delivery-room stabilization has also been observed to reduce the rate of moderate hypothermia on admission to the NICU, with no increased risk of hyperthermia.20
Find clinical evidence and practice guidelines for delivering nasal high flow (aka HFNC) therapy.
The heating and humidifying of respiratory gases is crucial for intubated patients. Learn about humidification devices, including active and passive.
Featuring under nose NIV masks (F&P Visairo) and full face NIV masks - (F&P Nivairo), with vented and non-vented options to suit your hospital NIV mask needs.
Establish effective spontaneous breathing or assist ventilation of the lungs
Respiratory support that replaces spontaneous breathing
Noninvasive respiratory support that provides a continuous distending pressure
Noninvasive respiratory support that delivers high flows of blended air and oxygen
Designed to work in harmony with the way patients naturally breathe while they sleep
F&P SleepStyle - designed to strike the balance between comfort and effective treatment
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