Abstract
OBJECTIVES: Respiratory function monitors (RFM) provide objective feedback on respiratory parameters during face mask ventilation. While traditional RFMs display detailed waveforms, newer devices use simplified, colour-coded graphics. We aimed to compare three RFM feedback methods against a no-feedback approach, assessing ventilation parameters and user interpretation. METHODS: This simulation-based, crossover randomised study involved healthcare professionals at a tertiary neonatal centre, who received training on two RFMs: a "Coloured graphic" device (Monivent NeoTraining), offering monitor and sensor light feedback, and a "Flow curves" device (Respironics NM3). Participants performed positive pressure ventilation on a manikin across three phases: access to the "Coloured graphic" monitor and sensor light, "Light only", and access to the "Flow curves" monitor, evaluated against a control phase with no feedback. An interpretation assessment followed. The primary outcome was the median difference in mask leak (%) between the control and the three intervention phases. RESULTS: Data from 51 participants were analysed. Compared to the control, the median (IQR) mask leak (%) was significantly lower in the "Coloured graphic" phase (11% [7%-26%]; median difference: -13 [95% CI: -26 to -2]). No significant differences were observed in the "Light only" phase (22% [8%-39%]); median difference: -10 [95% CI: -25 to 5]), or "Flow curves" phase (44% [6%-73%]; median difference: 8 [95% CI: -2 to 18]). Although more participants correctly interpreted the "Coloured graphic" feedback, only a minority selected appropriate corrective actions. CONCLUSIONS: Objective feedback from the "Coloured graphic" RFM significantly reduced leak during mask ventilation.