• Prakash Kannan Loganathan, Charlotte Ashton, Emily Harrold, Sarah Wigston, Le Minh Thao Doan, and Annalisa Occhipinti.
• Neonatal Unit, James Cook University Hospital, Middlesbrough, UK.
• Paediatr Anaesth. 2024 Oct 7.

BackgroundNeonatal resuscitation airway training can be difficult as there is no feedback on the face mask technique. "JUNO" is a training respiratory function monitor that provides feedback on mask leak, ventilatory rate, and tidal volume.ObjectiveTo evaluate whether the use of the JUNO improves face mask ventilation techniques in manikin models.MethodsWe conducted an observational cross-over study with our unit staff. Following instructions, each participant performed a single-person technique, followed by a two-person technique with no JUNO feedback. This was repeated with JUNO feedback visible. A similar sequence was performed both in term and preterm manikins, giving a total of 8 sequences. Each participant was instructed to perform 1 min of positive pressure ventilation providing 30 inflations/minute for all of the simulations. Each of the simulation data underwent a data cleaning process.ResultsThirty-eight subjects provided a total of 304 sequences of positive pressure ventilation. A total of 13 354 inflations were analyzed. The feedback group had significantly lower rates of inflations with leak >60%, lower rates of excessive tidal volumes, lower mean leak percentage, and a lower mean inspiratory tidal volumes. When analyzed based on the technique (single person and two-person), similar positive results were noted in the "feedback group", across all the strata of staff. All of the staff reported that JUNO improved their ventilation technique and would recommend it for staff training.ConclusionsThe use of JUNO significantly improved mask ventilation consistently across manikin types, staff roles, and techniques (either single- or two-person).© 2024 John Wiley & Sons Ltd.

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