Resuscitation

Optimal resuscitation is the application of positive pressure to inflate the lungs and achieve maximum alveolar recruitment – without causing further damage.

Safe, Consistent and Optimal Resuscitation

Protect with Controlled Pressures

Optimal resuscitation is the application of positive pressure to inflate the lungs and achieve maximum alveolar recruitment – without causing further damage (and while establishing Functional Residual Capacity (FRC)).

Infant T-Piece Resuscitation has the benefit of providing controlled and precise pressures to help prevent lung over-distension. These controlled pressures, Peak Inspiratory Pressure (PIP) and Positive End Expiratory Pressure (PEEP), are delivered more accurately when compared with a self-inflating bag.

Benefits of Infant T-Piece Resuscitation

Infant	Clinician
Inflates an infant’s lungs with controlled pressures¹	The operators' experience, training, concentration and fatigue level do not affect the pressures delivered^{1, 2}which is highly reassuring for the clinician
Oxygen concentrations from 21 to 100% can be delivered³	PEEP can be used during surfactant delivery
Infant T-Piece Resuscitation with Optimal Humidity can prevent airway drying4	Can provide consistent PEEP during transport or ventilator circuit change
Consistent PEEP can improve lung compliance and establish FRC^5,6	Initial sustained inflations can be delivered to establish lung volume⁶
	Can deliver ideal inspiratory versus expiratory ratio – allows for better gas exchange

Roehr CC, Kelm M, Fischer HS, et al. Manual ventilation devices in neonatal resuscitation: Tidal volume and positive pressure-provision. Resuscitation. 2010 Feb;81(2):202-5. Epub 2009 Nov 17.
Roehr CC, Kelm M, Proquitte H, et al. Equipment and Operator Training Denote Manual Ventilation Performance in Neonatal Resuscitation. Am J Perinatol. 2010 Oct;27(9):753-8. Epub 2010 May 10.
Dawson JA, Davis PG, Kamlin CO, et al. Free-flow oxygen delivery using a T-piece resuscitator. Arch Dis Child Fetal Neonatal Ed. Sep 2007;92(5):F421.
Williams R, Rankin N, Smith T, et al. Relationship between the humidity and temperature of inspired gas and the function of the airway mucosa. Crit Care Med. 1996;24(11):1920-1929.
Te Pas AB, Walther FJ. Ventilation of very preterm infants in the delivery room. Current Pediatric Reviews. 2006;2(3):187-197.
Te Pas AB, Siew M, Wallace MJ, 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. May 2009;65(5):537-541.

View references

T-Piece Resuscitation facilitates maximum oxygenation while protecting the lungs from injury.

During T-Piece Resuscitation, gases conditioned to body temperature, 37 °C, and fully saturated with 44 mg/L of water vapor, help to:

Protect the pulmonary epithelium and reduce postnatal decrease in temperature
Prevent infant moisture loss (especially during prolonged resuscitation)
Reduce the risk of an inflammatory response occurring in the infant’s airway caused by drying
Restore natural balance and provide a level of humidity found normally in the airways