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Paediatric exhaled CO2 detector causes leaks

Objective To assess leakage caused by the Pedi-Cap. Methods Bench test I: Pedi-Caps were connected between the Neopuff and a test lung and placed underwater to detect the leak. Bench test II: the disposable Avea VarFlex Flow Transducer measured the leak. Retrospective analysis: recordings of intubations in the delivery room were analysed. Results The (rippled) male end of the Pedi-Cap is the origin of the leak. In bench test I, 32% of the Pedi-Caps caused inevitable extensive leaks and 34% caused leaks that diminished after sealing the end. In bench test II (n=44) and the retrospective analysis (n=17), the flow transducer measured 22% (18–60) and 39% (8–82) leakage, respectively. Leakage decreased after removal of the Pedi-Cap (before vs after; 17% (7–75) vs 4% (2–10), p=0.004). Conclusion The Pedi-Cap causes the leak which can compromise respiratory support. We recommend to remove the Pedi-Cap directly after change of colour and to be cautious when using the device as evaluation tool.