Affiliations: [a]
Maimonides Medical Center, Brooklyn, NY, USA
| [b]
New York Presbyterian Morgan Stanley Children’s Hospital, New York, NY, USA
Correspondence:
[*]
Address for correspondence: Mehbeen Khan, Maimonides Medical Center, Department of Pediatrics, 4802 10th Avenue, Brooklyn, NY 11219, USA. Tel.: +718 283 8853; Fax: +718 635 8872; E-mail: [email protected].
Abstract: OBJECTIVE:To compare proportions of target range tidal volumes achieved with the self-inflating bag vs. the T-piece in resuscitation of preterm newborns at delivery. STUDY DESIGN:This randomized controlled trial was conducted at a tertiary Children’s Hospital. 20 preterm infants≤32 weeks’ gestational age with no congenital anomalies who needed positive pressure ventilation after birth were enrolled. Positive pressure ventilation was provided with the self-inflating bag or T-piece resuscitator. The primary outcome was proportion of inflations within a target range of 4–8 ml/kg. Chi-square and logistical regression analyses were performed. RESULTS:In the self-inflating bag (SIB) group 29% of inflations (117/419) and in the T-Piece (TP) group 51% of inflations (300/590) delivered expiratory tidal volume (TVe) of 4–8 ml/kg (p < 65.001). In the SIB group 60% of all inflations (254/419), and in the TP group 35% of all inflations (204/590) delivered TVe < 4 ml/kg (p < 0.001). In the SIB group 11% of all inflations (48/419), and in the TP group, 15% of all inflations (86/590) delivered TVe > 8 ml/kg (p = 0.18). The OR of having expiratory tidal volume of 4–8 ml/kg using the T-piece was 1.8 (CI 1.1–3.1), p = 0.02. CONCLUSION:Manual inflations provided by the TP deliver expiratory tidal volumes in the range of 4–8 ml/kg more consistently than SIB.
