OBJECTIVES Effective bag-valve-mask ventilation is critical for reducing perinatal asphyxia-related neonatal deaths; however, providers often fail to achieve and maintain effective ventilation. The Augmented Infant Resuscitator (AIR) attaches to bag-valve-masks and provides visual feedback on air leaks, blocked airways, harsh breaths, and improper ventilatory rates. We evaluated the effect of this real-time-digital feedback on ventilation quality and the effective determination of airway integrity in a randomized controlled study in Uganda and the United States. METHODS Birth attendants trained in newborn resuscitation were randomized to receive either real-time AIR device feedback (intervention) or no feedback (control) during ventilation exercises. Intervention-arm participants received a 2-minute orientation on interpreting AIR feedback using a single-page iconography chart. All participants were randomly assigned to 3 blinded ventilation scenarios on identical-appearing manikins with airways that were either normal, significantly leaking air, or obstructed. RESULTS We enrolled 270 birth attendants: 77.8% from Uganda and 22.2% from the United States. Birth attendants receiving AIR feedback achieved effective ventilation 2.0 times faster: intervention mean 13.8s (95% confidence interval 10.6-17.1) versus 27.9s (21.6-34.3) for controls (P < .001). The duration of effective ventilation was 1.5 times longer: intervention mean 72.1s (66.7-77.5) versus 47.9s (41.6-54.2) for controls (P < .001). AIR feedback was associated with significantly more accurate and faster airway condition assessment (intervention mean 43.7s [40.5-47.0] versus 55.6s [51.6-59.6]). CONCLUSIONS Providers receiving real-time-digital AIR device feedback achieved effective ventilation significantly faster, maintained it longer, and determined airway condition faster and more accurately than providers in the control group.

中文翻译：

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实时数字反馈装置和模拟新生儿通气质量。

目标 有效的球囊-瓣膜-面罩通气对于减少围产期窒息相关的新生儿死亡至关重要；然而，提供者常常无法实现和维持有效的通气。增强型婴儿复苏器 (AIR) 连接到气囊阀面罩上，并提供有关漏气、气道阻塞、呼吸困难和通气速率不当的视觉反馈。我们在乌干达和美国进行的一项随机对照研究中评估了这种实时数字反馈对通气质量和有效确定气道完整性的影响。方法接受过新生儿复苏培训的接生员被随机分配，在通气练习期间接受实时 AIR 设备反馈（干预）或无反馈（控制）。干预组参与者接受了 2 分钟的指导，了解如何使用单页图像图表解释 AIR 反馈。所有参与者被随机分配到 3 个盲态通气场景，这些场景均使用外观相同的人体模型，气道要么正常，要么严重漏气，要么阻塞。结果 我们招募了 270 名助产士：77.8% 来自乌干达，22.2% 来自美国。接受 AIR 反馈的助产士实现有效通气的速度快了 2.0 倍：干预平均为 13.8 秒（95% 置信区间 10.6-17.1），而对照组为 27.9 秒（21.6-34.3）（P < .001）。有效通气的持续时间延长了 1.5 倍：干预平均为 72.1 秒 (66.7-77.5)，而对照组为 47.9 秒 (41.6-54.2) (P < .001)。AIR 反馈与更准确、更快速的气道状况评估相关（干预平均时间为 43.7 秒 [40.5-47.0] 对比 55.6 秒 [51.6-59.6]）。结论 与对照组的提供者相比，接收实时数字 AIR 设备反馈的提供者实现有效通气的速度明显更快，保持时间更长，并且更快、更准确地确定气道状况。