138 Mask or Nasal Tube to Provide Positive Pressure Ventilation (PPV) to Preterm Infants in the Delivery Room (DR)-The Mont Trial

Background For initial PPV a face mask is used, but obstruction and leak often occurs. A nasal tube is an alternative interface in the DR to provide PPV. Its safety and efficacy have not been tested in a large RCT in extremely preterm infants. Objective To determine whether a single nasal tube is mo...

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Published in:Archives of disease in childhood 2012-10, Vol.97 (Suppl 2), p.A39-A39
Main Authors: Kamlin, COF, Schilleman, K, Dawson, JA, Lopriore, E, Donath, S, Schmoelzer, GM, Walther, FJ, Davis, PG, Pas, AB te
Format: Article
Language:English
Subjects:
Air leakage
Infants
Pregnancy
Premature Infants
Protective equipment
Ventilation
Young Children
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container_end_page A39
container_issue Suppl 2
container_start_page A39
container_title Archives of disease in childhood
container_volume 97
creator Kamlin, COF
Schilleman, K
Dawson, JA
Lopriore, E
Donath, S
Schmoelzer, GM
Walther, FJ
Davis, PG
Pas, AB te
description Background For initial PPV a face mask is used, but obstruction and leak often occurs. A nasal tube is an alternative interface in the DR to provide PPV. Its safety and efficacy have not been tested in a large RCT in extremely preterm infants. Objective To determine whether a single nasal tube is more effective than face mask during the stabilisation of infants born between 24 and 29 weeks. Design and methods An RCT performed in Melbourne and Leiden. Infants were randomized immediately prior to birth to receive PPV using a T-piece with either a nasal tube or round mask. Resuscitation guidelines were standardised. Criteria for intubation: cardiac compressions, apnea, CPAP >7cmH2O and FiO2 >0.4. Primary outcome: intubation in the first 24 hours from birth. Results In total 368 infants were randomized. Baseline variables, primary and secondary outcomes were similar (table). Abstract 138 Table 1Baseline characteristics and outcome Mask (N= 187) Nasal Tube (N= 181) OR (95% CI) GA (wks) 27 (26–29) 27 (26–28) - Birthweight (g) 1000 (807–1196) 946 (780–1182) - Intubation in first 24hrs 102 (54) 97 (54) 0.96 (0.64–1.45) Intubation in DR 58 (31) 41 (23) 0.65 (0.41–1.04) Air Leak 14 (8) 11 (6) 0.80 (0.35–1.81) Total (MV+CPAP) days of ventilation 13 (6–41) 16 (4–41) NS Death or BPD 68 (36) 64 (35) 0.96 (0.62–1.47) Conclusions In infants < 30 weeks gestation receiving PPV in the DR, there were no differences in short term outcomes using the nasal tube compared to the face mask.
doi_str_mv 10.1136/archdischild-2012-302724.0138
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A nasal tube is an alternative interface in the DR to provide PPV. Its safety and efficacy have not been tested in a large RCT in extremely preterm infants. Objective To determine whether a single nasal tube is more effective than face mask during the stabilisation of infants born between 24 and 29 weeks. Design and methods An RCT performed in Melbourne and Leiden. Infants were randomized immediately prior to birth to receive PPV using a T-piece with either a nasal tube or round mask. Resuscitation guidelines were standardised. Criteria for intubation: cardiac compressions, apnea, CPAP &gt;7cmH2O and FiO2 &gt;0.4. Primary outcome: intubation in the first 24 hours from birth. Results In total 368 infants were randomized. Baseline variables, primary and secondary outcomes were similar (table). Abstract 138 Table 1Baseline characteristics and outcome Mask (N= 187) Nasal Tube (N= 181) OR (95% CI) GA (wks) 27 (26–29) 27 (26–28) - Birthweight (g) 1000 (807–1196) 946 (780–1182) - Intubation in first 24hrs 102 (54) 97 (54) 0.96 (0.64–1.45) Intubation in DR 58 (31) 41 (23) 0.65 (0.41–1.04) Air Leak 14 (8) 11 (6) 0.80 (0.35–1.81) Total (MV+CPAP) days of ventilation 13 (6–41) 16 (4–41) NS Death or BPD 68 (36) 64 (35) 0.96 (0.62–1.47) Conclusions In infants &lt; 30 weeks gestation receiving PPV in the DR, there were no differences in short term outcomes using the nasal tube compared to the face mask.</description><identifier>ISSN: 0003-9888</identifier><identifier>EISSN: 1468-2044</identifier><identifier>DOI: 10.1136/archdischild-2012-302724.0138</identifier><identifier>CODEN: ADCHAK</identifier><language>eng</language><publisher>London: BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health</publisher><subject>Air leakage ; Infants ; Pregnancy ; Premature Infants ; Protective equipment ; Ventilation ; Young Children</subject><ispartof>Archives of disease in childhood, 2012-10, Vol.97 (Suppl 2), p.A39-A39</ispartof><rights>2012, Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.</rights><rights>Copyright: 2012 (c) 2012, Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.proquest.com/docview/1828858198/fulltextPDF?pq-origsite=primo$$EPDF$$P50$$Gproquest$$H</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/1828858198?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>314,780,784,21378,21394,27924,27925,33611,33877,43733,43880,74221,74397</link.rule.ids></links><search><creatorcontrib>Kamlin, COF</creatorcontrib><creatorcontrib>Schilleman, K</creatorcontrib><creatorcontrib>Dawson, JA</creatorcontrib><creatorcontrib>Lopriore, E</creatorcontrib><creatorcontrib>Donath, S</creatorcontrib><creatorcontrib>Schmoelzer, GM</creatorcontrib><creatorcontrib>Walther, FJ</creatorcontrib><creatorcontrib>Davis, PG</creatorcontrib><creatorcontrib>Pas, AB te</creatorcontrib><title>138 Mask or Nasal Tube to Provide Positive Pressure Ventilation (PPV) to Preterm Infants in the Delivery Room (DR)-The Mont Trial</title><title>Archives of disease in childhood</title><addtitle>Arch Dis Child</addtitle><description>Background For initial PPV a face mask is used, but obstruction and leak often occurs. A nasal tube is an alternative interface in the DR to provide PPV. Its safety and efficacy have not been tested in a large RCT in extremely preterm infants. Objective To determine whether a single nasal tube is more effective than face mask during the stabilisation of infants born between 24 and 29 weeks. Design and methods An RCT performed in Melbourne and Leiden. Infants were randomized immediately prior to birth to receive PPV using a T-piece with either a nasal tube or round mask. Resuscitation guidelines were standardised. Criteria for intubation: cardiac compressions, apnea, CPAP &gt;7cmH2O and FiO2 &gt;0.4. Primary outcome: intubation in the first 24 hours from birth. Results In total 368 infants were randomized. Baseline variables, primary and secondary outcomes were similar (table). Abstract 138 Table 1Baseline characteristics and outcome Mask (N= 187) Nasal Tube (N= 181) OR (95% CI) GA (wks) 27 (26–29) 27 (26–28) - Birthweight (g) 1000 (807–1196) 946 (780–1182) - Intubation in first 24hrs 102 (54) 97 (54) 0.96 (0.64–1.45) Intubation in DR 58 (31) 41 (23) 0.65 (0.41–1.04) Air Leak 14 (8) 11 (6) 0.80 (0.35–1.81) Total (MV+CPAP) days of ventilation 13 (6–41) 16 (4–41) NS Death or BPD 68 (36) 64 (35) 0.96 (0.62–1.47) Conclusions In infants &lt; 30 weeks gestation receiving PPV in the DR, there were no differences in short term outcomes using the nasal tube compared to the face mask.</description><subject>Air leakage</subject><subject>Infants</subject><subject>Pregnancy</subject><subject>Premature Infants</subject><subject>Protective equipment</subject><subject>Ventilation</subject><subject>Young Children</subject><issn>0003-9888</issn><issn>1468-2044</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>ALSLI</sourceid><sourceid>CJNVE</sourceid><sourceid>M0P</sourceid><recordid>eNqVkE1v00AQhlcIJELhP6yEkNqDy37Znhw4QAqlqC1RFHLgshrbY2VTx1t2NxU98s_ZyAhx5TSj0fO-Iz2MvZHiXEpdvcXQbjsX260bukIJqQotVK3MuZAanrCZNBXkuzFP2UwIoYs5ADxnL2LciUwD6Bn7lVF-g_GO-8BvMeLA14eGePJ8GfyD64gvfXTJPeQlUIyHQHxDY3IDJudHfrpcbs4mnBKFPb8aexxT5G7kaUv8goacDY985f2en16szop1Pt_4MfF1cDi8ZM96HCK9-jNP2LdPH9eLz8X118urxfvrolHKQNG02FKPpdQECuZV1bZYKS20MVDWgB2KkpShFqCnpkaopZ53JZGqQaJR-oS9nnrvg_9xoJjszh_CmF9amRuhBDmHTL2bqDb4GAP19j64PYZHK4U9Wrf_WrdH63aybo_Wc76Y8i4m-vk3jOHOVrWuS3u7WdgP5Xf9ZSMu7SrzMPHNfvefr34DyxCZkQ</recordid><startdate>201210</startdate><enddate>201210</enddate><creator>Kamlin, COF</creator><creator>Schilleman, K</creator><creator>Dawson, JA</creator><creator>Lopriore, E</creator><creator>Donath, S</creator><creator>Schmoelzer, GM</creator><creator>Walther, FJ</creator><creator>Davis, PG</creator><creator>Pas, AB te</creator><general>BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health</general><general>BMJ Publishing Group LTD</general><scope>BSCLL</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>0-V</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88B</scope><scope>88E</scope><scope>88I</scope><scope>8A4</scope><scope>8AF</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ALSLI</scope><scope>AN0</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>BTHHO</scope><scope>CCPQU</scope><scope>CJNVE</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9-</scope><scope>K9.</scope><scope>LK8</scope><scope>M0P</scope><scope>M0R</scope><scope>M0S</scope><scope>M1P</scope><scope>M2P</scope><scope>M7P</scope><scope>PQEDU</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>Q9U</scope></search><sort><creationdate>201210</creationdate><title>138 Mask or Nasal Tube to Provide Positive Pressure Ventilation (PPV) to Preterm Infants in the Delivery Room (DR)-The Mont Trial</title><author>Kamlin, COF ; 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A nasal tube is an alternative interface in the DR to provide PPV. Its safety and efficacy have not been tested in a large RCT in extremely preterm infants. Objective To determine whether a single nasal tube is more effective than face mask during the stabilisation of infants born between 24 and 29 weeks. Design and methods An RCT performed in Melbourne and Leiden. Infants were randomized immediately prior to birth to receive PPV using a T-piece with either a nasal tube or round mask. Resuscitation guidelines were standardised. Criteria for intubation: cardiac compressions, apnea, CPAP &gt;7cmH2O and FiO2 &gt;0.4. Primary outcome: intubation in the first 24 hours from birth. Results In total 368 infants were randomized. Baseline variables, primary and secondary outcomes were similar (table). Abstract 138 Table 1Baseline characteristics and outcome Mask (N= 187) Nasal Tube (N= 181) OR (95% CI) GA (wks) 27 (26–29) 27 (26–28) - Birthweight (g) 1000 (807–1196) 946 (780–1182) - Intubation in first 24hrs 102 (54) 97 (54) 0.96 (0.64–1.45) Intubation in DR 58 (31) 41 (23) 0.65 (0.41–1.04) Air Leak 14 (8) 11 (6) 0.80 (0.35–1.81) Total (MV+CPAP) days of ventilation 13 (6–41) 16 (4–41) NS Death or BPD 68 (36) 64 (35) 0.96 (0.62–1.47) Conclusions In infants &lt; 30 weeks gestation receiving PPV in the DR, there were no differences in short term outcomes using the nasal tube compared to the face mask.</abstract><cop>London</cop><pub>BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health</pub><doi>10.1136/archdischild-2012-302724.0138</doi><oa>free_for_read</oa></addata></record>
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subjects Air leakage
Infants
Pregnancy
Premature Infants
Protective equipment
Ventilation
Young Children
title 138 Mask or Nasal Tube to Provide Positive Pressure Ventilation (PPV) to Preterm Infants in the Delivery Room (DR)-The Mont Trial
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