T-piece versus self-inflating bag ventilation in preterm neonates at birth

Guinsburg, Ruth; Almeida, Maria Fernanda Branco de; Castro, Jarbas C.; Gonçalves‐Ferri, Walusa Assad; Marques, Patrícia Franco; Caldas, Jamil Pedro de Siqueira; Krebs, Vera Lúcia Jornada; Rugolo, Lígia Maria Suppo de Souza; Almeida, João Henrique Carvalho Leme de; Luz, Jorge Hecker; Procianoy, Renato S.; Duarte, José Luiz Muniz Bandeira; Machado, Márcia Gomes Penido; Ferreira, Daniela Marques de Lima Mota; Filho, Navantino Alves; Diniz, Edna Maria de Albuquerque; Santos, Juliana Pereira dos; Acquesta, Ana Lúcia; Santos, Cristina Nunes dos; González, Maria Rafaela Conde; Silva, Regina P. G. Vieira Cavalcanti da; Meneses, Jucile; Lopes, José Maria de Andrade; Martinez, Francisco Eulógio

doi:10.1136/archdischild-2016-312360

Cited by 45 publications

(34 citation statements)

References 22 publications

(17 reference statements)

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“…They demonstrated that neonates in TPR group required positive pressure ventilation for a lesser duration and had lower intubation rates [16]. A Brazilian prospective cohort study of 1962 inborn preterm infants showed that TPR, as compared to SIB, increased the odds of survival to discharge without major morbidities [17]. In the present study, the requirement of second dose of surfactant was significantly lower in the TPR group.…”

Section: Discussionsupporting

confidence: 47%

Effect of T-Piece Resuscitator versus Self Inflating Bag on Arterial CO2 Levels in Preterm Neonates

2020

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Objective To compare the effect of self-inflating bag (SIB) vs. T-piece resuscitator (TPR) on PaCO 2 levels, when used for brief manual ventilation during administration of first dose of surfactant. Methods Preterm neonates were randomized to receive positive pressure ventilation with either self-inflating bag or T-piece resuscitator during administration of first dose of surfactant. Arterial blood gases were obtained at baseline and 1 h after the intervention. Primary outcome was the mean change in PaCO 2 levels 1 h after the intervention. Results Eighty neonates were enrolled (40 in each group). The drop in PaCO 2 at 1 h was significantly greater in the self inflating bag group as compared to the T-piece resuscitator group [8.96 ± 9.06 mmHg vs. 1.37 ± 9.06 mmHg, Mean difference = 7.58 mmHg, (95% CI: 3.78 to 11.4); P < 0.01]. The PaCO 2 change was also statistically significant in the subgroup of infants that required only non-invasive ventilation. The need for second dose of surfactant was higher in the self-inflating bag group [77% vs. 55%, RR-1.41 (95% CI: 1.02 to 1.94); P = 0.03]. Conclusions T-piece resuscitator results in smaller reduction in PaCO 2 levels compared to the self inflating bag, when used for brief manual ventilation during surfactant administration.

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Section: Discussionsupporting

confidence: 47%

Effect of T-Piece Resuscitator versus Self Inflating Bag on Arterial CO2 Levels in Preterm Neonates

2020

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“…After adjusting for important maternal and infant demographic characteristics, infants who received PPV with the T-piece were significantly more likely to survive to discharge without bronchopulmonary dysplasia or severe intraventricular hemorrhage, or periventricular leukomalacia. [64]…”

Section: Clinical Evidence For the Most Effective Methods To Provide mentioning

confidence: 99%

Effective ventilation: The most critical intervention for successful delivery room resuscitation

Foglia

Pas

2018

Seminars in Fetal and Neonatal Medicine

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Lung aeration is the critical first step that triggers the transition from fetal to postnatal cardiopulmonary physiology after birth. When an infant is apneic or does not breathe sufficiently, intervention is needed to support this transition. Effective ventilation is therefore the cornerstone of neonatal resuscitation. In this article, we review the physiology of cardiopulmonary transition at birth, with particular attention to factors the caregiver should consider when providing ventilation. We then summarize the available clinical evidence for strategies to monitor and perform positive pressure ventilation in the delivery room setting.

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“…Outcome measures included survival to hospital discharge without bronchopulmonary dysplasia, severe peri-intraventricular haemorrhage, and periventricular leukomalacia. The study showed that the T-piece resuscitator resulted in patients being more likely to survive to hospital discharge while avoiding major morbidities 30 .…”

Section: Neonatal Mask Ventilationmentioning

confidence: 97%

Mask ventilation

Baker

2018

F1000Res

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Effective mask ventilation is an essential skill for any practitioner engaged in airway management. Recent methods to objectively describe mask ventilation using waveform capnography help practitioners to monitor and communicate the effectiveness of mask ventilation. Gentle mask ventilation is now considered acceptable during rapid sequence induction/intubation after loss of consciousness, hence reducing the incidence of hypoxia prior to tracheal intubation. Mask ventilation can be enhanced with muscle relaxation, a double C-E grip, and jaw thrust. This is particularly relevant for patients with reduced apnoea time. An awareness of the complications associated with mask ventilation may help reduce the morbidity associated with this technique. Effective ventilation technique and optimum device selection are important aspects for resuscitation of the newborn. Teaching correct establishment and maintenance of mask ventilation is essential for safe patient care. This review will examine some of the latest developments concerning mask ventilation for adult and paediatric patients.

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T-piece versus self-inflating bag ventilation in preterm neonates at birth

Abstract: This study is the first that highlights the effectiveness of T-piece resuscitator ventilation in improving relevant outcomes in preterm neonates.

Cited by 45 publications

References 22 publications

Effect of T-Piece Resuscitator versus Self Inflating Bag on Arterial CO2 Levels in Preterm Neonates

Effect of T-Piece Resuscitator versus Self Inflating Bag on Arterial CO2 Levels in Preterm Neonates

Effective ventilation: The most critical intervention for successful delivery room resuscitation

Mask ventilation

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