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SHR Neuro Cancer Cardio Lipid Metab Microb
Kamlin, CO; Schilleman, K; Dawson, JA; Lopriore, E; Donath, SM; Schmölzer, GM; Walther, FJ; Davis, PG; Te Pas, AB.
Mask versus nasal tube for stabilization of preterm infants at birth: a randomized controlled trial.
Pediatrics. 2013; 132(2):e381-e388
Doi: 10.1542/peds.2013-0361
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- Co-authors Med Uni Graz
- Schmölzer Georg
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- Abstract:
- OBJECTIVE: Positive-pressure ventilation (PPV) using a manual ventilation device and a face mask is recommended for compromised newborn infants in the delivery room (DR). Mask ventilation is associated with airway obstruction and leak. A nasal tube is an alternative interface, but its safety and efficacy have not been tested in extremely preterm infants. METHODS: An unblinded randomized controlled trial was conducted in Australia, and the Netherlands. Infants were stratified by gestational age (24-25/26-29 weeks) and center. Immediately before birth infants were randomly assigned to receive PPV and/or continuous positive airway pressure with either a nasal tube or a size 00 soft, round silicone mask. Resuscitation protocols were standardized; respiratory support was provided using a T-piece device commencing in room air. Criteria for intubation included need for cardiac compressions, apnea, continuous positive airway pressure >7 cm H2O, and fraction of inspired oxygen >0.4. Primary outcome was endotracheal intubation in the first 24 hours from birth. RESULTS: Three hundred sixty-three infants were randomly assigned; the study terminated early on the grounds of futility. Baseline variables were similar between groups. Intubation rates in the first 24 hours were 54% and 55% in the nasal tube and face mask groups, respectively (odds ratio: 0.97; 95% confidence interval: 0.63-1.50). There were no important differences in any of the secondary outcomes within the whole cohort or between the 2 gestational age subgroups. CONCLUSIONS: In infants at <30 weeks' gestation receiving PPV in the DR, there were no differences in short-term outcomes using the nasal tube compared with the face mask.
- Find related publications in this database (using NLM MeSH Indexing)
- Airway Obstruction - etiology
- Cohort Studies -
- Continuous Positive Airway Pressure - instrumentation
- Early Termination of Clinical Trials -
- Equipment Failure Analysis -
- Gestational Age -
- Humans -
- Infant, Low Birth Weight -
- Infant, Newborn -
- Infant, Very Low Birth Weight -
- Intubation, Intratracheal -
- Masks -
- Masks -
- Respiratory Distress Syndrome, Newborn - therapy
- Resuscitation -
- Resuscitation -
- Find related publications in this database (Keywords)
- infant
- newborn
- neonatal resuscitation
- prematurity
- positive-pressure ventilation
- nasal ventilation