Anatomic accuracy, physiologic characteristics, and fidelity of very low birth weight infant airway simulators
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Anatomic accuracy, physiologic characteristics, and fidelity of very low birth weight infant airway simulators. / Hinojosa, Patricia Lengua; Eifinger, Frank; 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; Deindl, Philipp.
In: PEDIATR RES, Vol. 92, No. 3, 09.2022, p. 783-790.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Anatomic accuracy, physiologic characteristics, and fidelity of very low birth weight infant airway simulators
AU - Hinojosa, Patricia Lengua
AU - Eifinger, Frank
AU - Wagner, Michael
AU - Herrmann, Jochen
AU - Wolf, Monika
AU - Ebenebe, Chinedu Ulrich
AU - von der Wense, Axel
AU - Jung, Philipp
AU - Mai, Aram
AU - Bohnhorst, Bettina
AU - Longardt, Ann Carolin
AU - Hillebrand, Georg
AU - Schmidtke, Susanne
AU - Guthmann, Florian
AU - Aderhold, Martina
AU - Schwake, Ida
AU - Sprinz, Maria
AU - Singer, Dominique
AU - Deindl, Philipp
N1 - © 2021. The Author(s).
PY - 2022/9
Y1 - 2022/9
N2 - 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.
AB - 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.
U2 - 10.1038/s41390-021-01823-w
DO - 10.1038/s41390-021-01823-w
M3 - SCORING: Journal article
C2 - 34750523
VL - 92
SP - 783
EP - 790
JO - PEDIATR RES
JF - PEDIATR RES
SN - 0031-3998
IS - 3
ER -