Background and aim Current guidelines recommend self-inflating bags (SIB), flow-inflating bags and T-piece resuscitators for manual ventilation of neonates. They further recommend the use of PEEP. Using a SIB, PEEP can be provided by attaching a PEEP valve to the device. These valves are mostly reusable items. However, several studies could show that multi-use PEEP valves could only deliver insufficient levels of PEEPand that their reliability was further decreased by repeated sterilisation cycles.

The aim of our study was to test whether single-use PEEP valves reliably delivered the set PEEP.

Methods Ten new single-use PEEP valves from 5 different manufacturers (2 valves each from Laerdal (5–20 cmH₂O), DROH (0–10 cmH₂O), Vital Signs (5–20 cmH₂O), medisize (5–20 cmH₂O), Ambu (0–20 cmH₂O)) were attached to an electromechanically driven SIB to ventilate a manikin simulating a 1 kg preterm infant (PIP 20 cm H2O, RR 60/min). The delivered PEEP was measured and analysed.

Results The valves delivered a mean (SD) PEEP of 3.5 (1.9)cmH₂O when set to 5 cmH₂O and 5.6 (2.9) cmH₂O when set to 10 cmH₂O. One valve could not deliver any PEEP, the second valve from the same manufacturer could only deliver 0.0 (0.0) and 1.4 (0.0) cmH₂O when set to 5 and 10 cmH₂O, respectively.

Conclusion Single-use PEEP valves could be used as an alternative to multi-use items to avoid damage caused by repeated sterilisation procedures. However, they could not reliably deliver the set PEEP. Operators should be aware of the valves‘ poor reliability and test them before each use.