Neonatal Resuscitation Using a Nasal Cannula: A Single-Center Experience

Paz, Pedro; Ramanathan, Rangasamy; Hernandez, Richard; Biniwale, Manoj

doi:10.1055/s-0034-1370350

Cited by 6 publications

(3 citation statements)

References 19 publications

(19 reference statements)

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“…Thus, the short NC is a valid alternative to the mask to start and optimize the assistance in the DR. Paz et al and Capasso et al have shown how the use of NCs in the DR reduces the rates of intubation. 7,17 Moreover, the short NC, positioned immediately after birth, provides oxygenation even if the intubation becomes necessary.…”

Section: Discussionmentioning

confidence: 99%

“…The use of RAM NC in the DR for resuscitation from a tertiary level neonatal center in the United States has been recently reported. 7 Interestingly, authors also used nasal intermittent positive pressure ventilation (NIPPV) as the mode of NIV, with a Tpiece and RAM NC as the patient-nasal interface. In this retrospective study of very low birth weight infants, they showed that positive pressure ventilation (PPV) use in DR using RAM NC resulted in less need for intubation, chest compressions, and epinephrine administration when compared with a face mask for PPV in the DR. 8 Other pulmonary recruitment strategies in the DR, such as the use of sustained inflation (SI) and caffeine in the DR, are currently being evaluated.…”

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confidence: 99%

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Pulmonary Recruitment Strategy in Preterm Neonates < 29 Weeks of Gestational Age to Reduce the Need for Intubation in the Delivery Room

Petrillo¹,

Valenzano²,

Franco³

et al. 2019

Amer J Perinatol

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Background The application of noninvasive ventilation (NIV) modalities from birth in the delivery room (DR) during fetal–neonatal transition reduces the need for invasive mechanical ventilation, mortality, and bronchopulmonary dysplasia (BPD). The use of a RAM nasal cannula (RAM NC) in the DR for resuscitation results in less need for intubation, chest compressions, and epinephrine administration when compared with using a face mask for PPV in the DR. Objective To evaluate the need for endotracheal intubation in the DR among extremely low gestational age neonates treated at birth with sustained inflation (SI) followed by a nasal continuous positive airway pressure (NCPAP) (range: 6–8 cm of H2O) delivered through the RAM NC. Study Design A retrospective study was conducted to compare the use of NIV techniques in the DR and the need for intubation in the DR in premature infants 23 to 28 weeks' gestational age from December 2016 to July 2018 (group A). These data were compared with those of premature inborn infants with similar GA born between April 2015 and November 2016 (group B). In the DR, immediately after birth, neonates in group A received SI through RAM NC followed by CPAP ranging from 6 to 8 cm H2O, whereas the neonates in group B were treated in the DR with SI administered through a face mask followed by the application of CPAP of 5 cm H2O delivered through a nasopharyngeal tube. Results A total of 65 preterm infants 23 to 28 weeks of gestational age, 31 in group A and 34 in group B, were included in the study. The percentage of neonates intubated in the DR was significantly lower in group A (p < 0.008). In both groups, no neonates died in the DR, and no one required epinephrine and/or chest compressions. For those neonates who did not require intubation in the DR, there was no significant difference in the average FiO2 on arrival in the neonatal intensive care unit, rate of intubation within 24 hours, and use of surfactant. The incidence of BPD was similar in the two groups. Only one infant in group A developed moderate BPD, and no one needed oxygen and/or ventilatory assistance at discharge. Mortality was similar in the two groups, with a slight prevalence in group B (27.7 vs. 19.2%). Conclusion SI with RAM NC followed by NCPAP ranging from 6 to 8 cm H2O, administered with RAM NC resulted in a significant reduction of intubation in the DR.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Pulmonary Recruitment Strategy in Preterm Neonates < 29 Weeks of Gestational Age to Reduce the Need for Intubation in the Delivery Room

Petrillo¹,

Valenzano²,

Franco³

et al. 2019

Amer J Perinatol

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“…During ventilation, an initial peak inspiratory pressure (PIP) of 30 cm H 2 O in term newborn infants should be used [18, 19, 53]. However, the optimum pressure, inflation time, and gas flow required to establish an effective functional residual capacity in depressed newborn infants is unknown.…”

Section: Respiratory Supportmentioning

confidence: 99%

Delivery Room Management of Asphyxiated Term and Near-Term Infants

et al. 2021

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Approximately 800,000 newborns die annually due to birth asphyxia. The resuscitation of asphyxiated term newly born infants often occurs unexpected and is challenging for healthcare providers as it demands experience and knowledge in neonatal resuscitation. Current neonatal resuscitation guidelines often focus on resuscitation of extremely and/or very preterm infants; however, the recommendations for asphyxiated term newborn infants differ in some aspects to those for preterm infants (i.e., respiratory support, supplemental oxygen, and temperature management). Since the update of the neonatal resuscitation guidelines in 2015, several studies examining various resuscitation approaches to improve the outcome of asphyxiated infants have been published. In this review, we discuss current recommendations and recent findings and provide an overview of delivery room management of asphyxiated term newborn infants.

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