Delivery Room Nasal Continuous Positive Airway Pressure as an Alternative to Intubation in 26- To 30-Week Neonates.

Nold, J. L.; Coleman, J. M.; Kilau, N.; Ferski, G.; Mammel, M. C.

doi:10.1097/00042871-200401001-00172

Cited by 2 publications

(5 citation statements)

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“…6,[38][39][40][41] In practice, a qualitative survey with 179 U.S. neonatologists showed that 59% used nasal CPAP and PEEP in the delivery room, while 63% used nasal CPAP with anesthetic bag and 27% with self-inflating bag with PEEP valve. The mean PEEP used was 4.7 cm H 2 O (2-10) in preterm infants and 5.3 cm H 2 O (3-10) in full-term newborns.…”

Section: Ventilationmentioning

confidence: 99%

“…42 At present, some institutions have shown that the use of nasal CPAP is feasible and safe when initiated immediately after birth in preterm infants with less than 28-30 weeks of gestational age. [39][40][41] However, randomized clinical trials are necessary to show the possible benefits, treatment criteria and risks of this therapy. 43 It should be highlighted that the recommendations made in the year 2000 1,2 for the resuscitation of extremely preterm infants do not contemplate the use of PEEP or CPAP in the delivery room.…”

Section: Ventilationmentioning

confidence: 99%

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A reanimação do prematuro extremo em sala de parto: controvérsias

Almeida¹,

Guinsburg²

2005

J. Pediatr. (Rio J.)

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Suggested citation: de Almeida MF, Guinsburg R. Controversies about the resuscitation of extremely preterm infants in the delivery room. J Pediatr (Rio J). 2005;81(1 Suppl):S3-S15. AbstractObjective: To describe the main controversies about resuscitation procedures performed in extremely low birth weight infants in the delivery room.Sources of data: Systematic review including articles from MEDLINE, SciELO and Cochrane Library, and abstracts published in national and international proceedings, using the keywords resuscitation, asphyxia, and newborn infant. Summary of the findings:The main controversies concern the oxygenation and ventilation of extremely low birth weight infants. The effects of oxygen concentrations between 21 and 100% need to be addressed. Appropriate inspiratory pressure, lung volume, and positive end-expiratory pressure parameters also need to be established in order to decrease barotrauma and volutrauma. The benefits of nasal continuous positive airway pressure may be determined through randomized clinical trials. On top of that, manual resuscitation devices have to be developed in order to optimize these ventilatory parameters and to reduce lung injury. So far, clinical trials on the administration of epinephrine, volume expanders, and sodium bicarbonate to extremely low birth weight infants have not been published. In addition, the main ethical dilemma concerns the decision of health professionals and parents not to initiate resuscitation procedures at very low gestational ages. Conclusions:In the future, guidelines may be modified based on the results of randomized and controlled clinical trials, as well as neurodevelopmental follow-up studies, involving extremely low birth weight infants submitted to resuscitation procedures in the delivery room.J Pediatr (Rio J). 2005;81(1 Suppl):S3-S15: Resuscitation, asphyxia neonatorum, newborn infant.

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Section: Ventilationmentioning

confidence: 99%

Section: Ventilationmentioning

confidence: 99%

A reanimação do prematuro extremo em sala de parto: controvérsias

Almeida¹,

Guinsburg²

2005

J. Pediatr. (Rio J.)

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“…Upton & Milner 31 examinaram as primeiras ventilações com pressão positiva em 30 recém-nascidos asfixiados, utilizando 40 movimentos/minuto com tempo inspiratório médio de 0,51 segundo, sem PEEP, e aplicando pressão necessária para obter a expansibilidade da caixa torácica. Dos 30 pacientes, 22 eram prematuros com média de peso ao nascer de 1.760 g (variação: 580-3.980) e 33 semanas de gestação (26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41)(42). Foi encontrada pressão média, durante as primeiras respirações, de 40 cm H 2 O (28-60).…”

Section: Ventilaçãounclassified

“…Alguns autores têm preconizado o uso de pressão positiva nasal contínua de vias aéreas (CPAP) na sala de parto como estratégia para diminuir o suporte da ventilação mecânica e o desenvolvimento da displasia broncopulmonar 6,[38][39][40][41] . Na prática, uma pesquisa qualitativa com 179 neonatologistas, nos Estados Unidos, mostrou que 59% utilizavam CPAP nasal e PEEP na sala de parto, sendo que 63% administravam CPAP nasal com balão anestésico e 27% com balão auto-inflável com válvula de PEEP.…”

Section: Ventilaçãounclassified

“…No momento, algumas instituições têm mostrado que a aplicação de CPAP nasal é factível e segura quando iniciada logo após o nascimento em prematuros com idade gestacional inferior a 28-30 semanas [39][40][41] . Entretanto, ensaios clínicos randomizados são necessários para demonstrar os possíveis benefícios, critérios de tratamento e riscos dessa terapia 43 .…”

Section: Ventilaçãounclassified

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