Document Detail

Comparison of Devices for Newborn Ventilation in the Delivery Room.
MedLine Citation:
PMID:  24690329     Owner:  NLM     Status:  Publisher    
OBJECTIVE: To evaluate the effectiveness and safety of a T-piece resuscitator compared with a self-inflating bag for providing mask ventilation to newborns at birth.
STUDY DESIGN: Newborns at ≥26 weeks gestational age receiving positive-pressure ventilation at birth were included in this multicenter cluster-randomized 2-period crossover trial. Positive-pressure ventilation was provided with either a self-inflating bag (self-inflating bag group) with or without a positive end-expiratory pressure valve or a T-piece with a positive end-expiratory pressure valve (T-piece group). Delivery room management followed American Academy of Pediatrics and International Liaison Committee on Resuscitation guidelines. The primary outcome was the proportion of newborns with heart rate (HR) ≥100 bpm at 2 minutes after birth.
RESULTS: A total of 1027 newborns were included. There was no statistically significant difference in the incidence of HR ≥100 bpm at 2 minutes after birth between the T-piece and self-inflating bag groups: 94% (479 of 511) and 90% (466 of 516), respectively (OR, 0.65; 95% CI, 0.41-1.05; P = .08). A total of 86 newborns (17%) in the T-piece group and 134 newborns (26%) in the self-inflating bag group were intubated in the delivery room (OR, 0.58; 95% CI, 0.4-0.8; P = .002). The mean ± SD maximum positive inspiratory pressure was 26 ± 2 cm H2O in the T-piece group vs 28 ± 5 cm H2O in the self-inflating bag group (P < .001). Air leaks, use of drugs/chest compressions, mortality, and days on mechanical ventilation did not differ significantly between groups.
CONCLUSION: There was no difference between the T-piece resuscitator and a self-inflating bag in achieving an HR of ≥100 bpm at 2 minutes in newborns ≥26 weeks gestational age resuscitated at birth. However, use of the T-piece decreased the intubation rate and the maximum pressures applied.
Edgardo Szyld; Adriana Aguilar; Gabriel A Musante; Nestor Vain; Luis Prudent; Jorge Fabres; Waldemar A Carlo;
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-3-29
Journal Detail:
Title:  The Journal of pediatrics     Volume:  -     ISSN:  1097-6833     ISO Abbreviation:  J. Pediatr.     Publication Date:  2014 Mar 
Date Detail:
Created Date:  2014-4-2     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0375410     Medline TA:  J Pediatr     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2014 Mosby, Inc. All rights reserved.
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