Oxygenation with T-Piece versus Self-Inflating Bag for Ventilation of Extremely Preterm Infants at Birth: A Randomized Controlled Trial

• Published in: The Journal of pediatrics Vol. 158; no. 6; pp. 912 - 918.e2
• Main Authors: Dawson, Jennifer A., PhD, Schmölzer, Georg M., MD, Kamlin, C.Omar F., D Med Sci, te Pas, Arjan B., MD, PhD, O’Donnell, Colm P.F., PhD, Donath, Susan M., MA, Davis, Peter G., MD, Morley, Colin J., MD
• Format: Journal Article
• Language: English
• Published: Maryland Heights, MO Mosby, Inc 01.06.2011; Elsevier
• Subjects: air; Biological and medical sciences; Diseases of mother, fetus and pregnancy; Equipment Design; Female; General aspects; Gestational Age; Gynecology. Andrology. Obstetrics; Humans; Infant, Newborn; Infant, Premature; infants; Insufflation - instrumentation; Intubation, Intratracheal - instrumentation; Male; Medical sciences; Neonatology; Oximetry - methods; oxygen; Oxygen - chemistry; Pediatrics; Positive-Pressure Respiration - instrumentation; Positive-Pressure Respiration - methods; pregnancy; Pregnancy. Fetus. Placenta; randomized clinical trials; Respiratory Distress Syndrome, Newborn - therapy; Surface-Active Agents - therapeutic use; surfactants; Positive pressure ventilation; SpO 2; Inflation time; RWH; CPAP; Continuous positive airway pressure; PEEP; Tidal volume; HR; V T; Functional residual capacity; Oxygen saturation; Heart rate; Positive end expiratory pressure; FRC; PIP; PPV; Royal Women’s Hospital; T i; V Te; Expiratory tidal volume; Peak inflating pressure; Human; Premature; Pediatrics; Pregnancy disorders; Premature delivery; Controlled therapeutic trial; Infant; Bag; Self; Randomized controlled trial; Newborn diseases; Randomization; Prematurity; Clinical trial; Ventilation; Oxygenation; Comparative study
• ISSN: 0022-3476; 1097-6833
• DOI: 10.1016/j.jpeds.2010.12.003

Objective To investigate whether infants <29 weeks gestation who receive positive pressure ventilation (PPV) immediately after birth with a T-piece have higher oxygen saturation (SpO2 ) measurements at 5 minutes than infants ventilated with a self inflating bag (SIB). Study design Randomized, controlled trial of T-piece or SIB ventilation in which SpO2 was recorded immediately after birth from the right hand/wrist with a Masimo Radical pulse oximeter, set at 2-second averaging and maximum sensitivity. All resuscitations started with air. Results Forty-one infants received PPV with a T-piece and 39 infants received PPV with a SIB. At 5 minutes after birth, there was no significant difference between the median (interquartile range) SpO2 in the T-piece and SIB groups (61% [13% to 72%] versus 55% [42% to 67%]; P = .27). More infants in the T-piece group received oxygen during delivery room resuscitation (41 [100%] versus 35 [90%], P = .04). There was no difference in the groups in the use of continuous positive airway pressure, endotracheal intubation, or administration of surfactant in the delivery room. Conclusion There was no significant difference in SpO2 at 5 minutes after birth in infants <29 weeks gestation given PPV with a T-piece or a SIB as used in this study.