Comparison of Devices for Newborn Ventilation in the Delivery Room

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 c...

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Bibliographic Details
Published in:The Journal of pediatrics 2014-08, Vol.165 (2), p.234-239.e3
Main Authors: Szyld, Edgardo, MD, MSc, Aguilar, Adriana, MD, Musante, Gabriel A., MD, MSc, Vain, Nestor, MD, Prudent, Luis, MD, Fabres, Jorge, MD, MSPH, Carlo, Waldemar A., MD
Format: Article
Language:English
Subjects:
Cardiopulmonary Resuscitation - instrumentation
Cross-Over Studies
Delivery Rooms
Female
Heart Rate - physiology
Humans
Infant, Newborn
Insufflation - instrumentation
Male
Pediatrics
Positive-Pressure Respiration - instrumentation
Treatment Outcome
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Summary: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 H2 O in the T-piece group vs 28 ± 5 cm H2 O in the self-inflating bag group ( P  
ISSN:0022-3476
1097-6833
DOI:10.1016/j.jpeds.2014.02.035