Anatomic accuracy, physiologic characteristics, and fidelity of very low birth weight infant airway simulators

Hinojosa, Patricia Lengua, Eifinger, Frank ORCID: 0000-0003-1758-6039, Wagner, Michael, Herrmann, Jochen, Wolf, Monika, Ebenebe, Chinedu Ulrich, von der Wense, Axel, Jung, Philipp, Mai, Aram, Bohnhorst, Bettina, Longardt, Ann Carolin, Hillebrand, Georg, Schmidtke, Susanne, Guthmann, Florian, Aderhold, Martina, Schwake, Ida, Sprinz, Maria, Singer, Dominique and Deindl, Philipp . Anatomic accuracy, physiologic characteristics, and fidelity of very low birth weight infant airway simulators. Pediatr. Res.. LONDON: SPRINGERNATURE. ISSN 1530-0447

Full text not available from this repository.

DOI:10.1038/s41390-021-01823-w

Abstract

Background Medical simulation training requires realistic simulators with high fidelity. This prospective multi-center study investigated anatomic precision, physiologic characteristics, and fidelity of four commercially available very low birth weight infant simulators. Methods We measured airway angles and distances in the simulators Premature AirwayPaul (SIMCharacters), Premature Anne (Laerdal Medical), Premie HAL S2209 (Gaumard), and Preterm Baby (Lifecast Body Simulation) using computer tomography and compared these to human cadavers of premature stillbirths. The simulators' physiologic characteristics were tested, and highly experienced experts rated their physical and functional fidelity. Results The airway angles corresponded to those of the reference cadavers in three simulators. The nasal inlet to glottis distance and the mouth aperture to glottis distance were only accurate in one simulator. All simulators had airway resistances up to 20 times higher and compliances up to 19 times lower than published reference values. Fifty-six highly experienced experts gave three simulators (Premature AirwayPaul: 5.1 +/- 1.0, Premature Anne 4.9 +/- 1.1, Preterm Baby 5.0 +/- 1.0) good overall ratings and one simulator (Premie HAL S2209: 2.8 +/- 1.0) an unfavorable rating. Conclusion The simulator physiology deviated significantly from preterm infants' reference values concerning resistance and compliance, potentially promoting a wrong ventilation technique. Impact Very low birth weight infant simulators showed physiological properties far deviating from corresponding patient reference values. Only ventilation with very high peak pressure achieved tidal volumes in the simulators, as aimed at in very low birth weight infants, potentially promoting a wrong ventilation technique. Compared to very low birth weight infant cadavers, most tested simulators accurately reproduced the anatomic angular relationships, but their airway dimensions were relatively too large for the represented body. The more professional experience the experts had, the lower they rated the very low birth weight infant simulators.

Item Type:

Journal Article

Creators:

Creators	Email	ORCID	ORCID Put Code
Hinojosa, Patricia Lengua	UNSPECIFIED	UNSPECIFIED	UNSPECIFIED
Eifinger, Frank	UNSPECIFIED	orcid.org/0000-0003-1758-6039	UNSPECIFIED
Wagner, Michael	UNSPECIFIED	UNSPECIFIED	UNSPECIFIED
Herrmann, Jochen	UNSPECIFIED	UNSPECIFIED	UNSPECIFIED
Wolf, Monika	UNSPECIFIED	UNSPECIFIED	UNSPECIFIED
Ebenebe, Chinedu Ulrich	UNSPECIFIED	UNSPECIFIED	UNSPECIFIED
von der Wense, Axel	UNSPECIFIED	UNSPECIFIED	UNSPECIFIED
Jung, Philipp	UNSPECIFIED	UNSPECIFIED	UNSPECIFIED
Mai, Aram	UNSPECIFIED	UNSPECIFIED	UNSPECIFIED
Bohnhorst, Bettina	UNSPECIFIED	UNSPECIFIED	UNSPECIFIED
Longardt, Ann Carolin	UNSPECIFIED	UNSPECIFIED	UNSPECIFIED
Hillebrand, Georg	UNSPECIFIED	UNSPECIFIED	UNSPECIFIED
Schmidtke, Susanne	UNSPECIFIED	UNSPECIFIED	UNSPECIFIED
Guthmann, Florian	UNSPECIFIED	UNSPECIFIED	UNSPECIFIED
Aderhold, Martina	UNSPECIFIED	UNSPECIFIED	UNSPECIFIED
Schwake, Ida	UNSPECIFIED	UNSPECIFIED	UNSPECIFIED
Sprinz, Maria	UNSPECIFIED	UNSPECIFIED	UNSPECIFIED
Singer, Dominique	UNSPECIFIED	UNSPECIFIED	UNSPECIFIED
Deindl, Philipp	UNSPECIFIED	UNSPECIFIED	UNSPECIFIED