Barriers to adoption of respiratory function monitors in neonatal resuscitation

Establishing effective ventilation is the cornerstone of successful neonatal resuscitation. Respiratory function monitors (RFMs) are devices used during delivery room (DR) resuscitation to provide real-time measurements of airway pressure, gas flow, tidal volume and mask leak during positive pressure ventilation. These data may help clinicians assess ventilation effectiveness and optimise respiratory support during the critical transition after birth. Despite observational data indicating that RFMs can provide ventilatory feedback during neonatal resuscitation, they have not been widely adopted in routine practice.1 This is often attributed to limited high-quality evidence and lack of guideline endorsement. However, adoption is likely hindered by multiple interacting factors (table 1). In addition to limitations in the evidence base, barriers related to usability, training and medical device development from conception to clinical implementation must also be considered. The challenges surrounding RFMs may reflect wider difficulties in translating promising neonatal technologies from research settings into routine clinical care.