Background and Aim Mask ventilation is commonly used for neonatal resuscitation. Variable leak and inconsistent tidal volumes are reported in mannequin and delivery room studies. We compared the spider hold (SH) against the two-point top hold (TPTH), and two-handed hold (THH) for delivering positive pressure ventilation (PPV).
Methods 53 participants from 5 professional groups provided PPV with each hold for 1 minute to a mannequin, using a T-piece resuscitator (PIP/PEEP 30/5 cmH2O, 40–60 inflations/min). Mask leak and expired tidal volume (TVE) were measured with a flow sensor. ANOVA was used to compare the average median leak from each participant for each hold and by professional group.
Results 7324 inflations were analysed.
The mean (SD) leak was 35(27)%, 38(34)% and 39(33)% for the TPTH, SH and THH respectively (p=0.003). The mean (SD) TVE was not significantly different between the three holds (p=0.09). The lowest mean (SD) leak was measured with the THH by registrars 13(14)% and highest by midwives with the THH 48(36)% (p=0.001).
Conclusion Each hold can be used to give PPV. The SH does not appear to reduce leak when compared to the other holds.