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Comparing Intubation Rates in the Delivery Room by Interface.
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- Author(s): Lamptey, Naa-Lamle; Kopec, Gretchen L.; Kaur, Harveen; Fischer, Ashley M.
- Source:
American Journal of Perinatology; 2024, Vol. 41 Issue 10, p1424-1431, 8p- Subject Terms:
HOSPITAL birthing centers; DATA analysis; NEONATAL intensive care units; LOGISTIC regression analysis; RETROSPECTIVE studies; NEONATAL intensive care; CHI-squared test; DESCRIPTIVE statistics; INTUBATION; ARTIFICIAL respiration; ACQUISITION of data; ANALYSIS of variance; STATISTICS; GESTATIONAL age; CARDIOPULMONARY resuscitation; BIRTH weight; CONFIDENCE intervals; CHILDREN - Source:
- Additional Information
- Abstract: Objective Positive pressure ventilation (PPV) is crucial to the resuscitation of newborns. Although neonates often require PPV at birth, the optimal interface has not been determined. Both binasal prongs and face masks were deemed acceptable by the International Liaison Committee on Resuscitation in 2010 and have been utilized at our center since 2016; however, the choice is by provider preference. Previous studies have suggested that binasal prongs may be more effective than face masks at avoiding intubation in the delivery room. The objective of this study is to compare intubation rates of binasal prongs versus face masks for delivery room resuscitation of neonates born < 30 weeks' gestation. Study Design This retrospective study compares delivery room intubation rates by interface for neonates < 30 weeks' gestation born between August 2016 and April 2021 at our level IV neonatal intensive care unit. Exclusion criteria included diagnosis of congenital diaphragmatic hernia, no PPV required, or no resuscitation attempted. Data collected included interface device, demographics, maternal data, delivery room data, admission data, and discharge outcomes. The three interface groups (binasal prongs, face mask, face mask, and binasal prongs) were compared utilizing chi-square, analysis of variance with post hoc analysis, and logistic regression. Results Mean gestational ages and birth weights for the groups were 27.6 weeks and 1,126 g, 25.7 weeks and 839 g, and 27.1 weeks and 1,028 g, respectively. Neonates resuscitated with face masks were 9.9 times more likely to be intubated in the delivery room and 10.8 times more likely to be intubated at 6 hours of life compared with those resuscitated with binasal prongs after logistic regression analysis. Conclusion The findings in our study support delivery room resuscitation with binasal prongs as a useful method in reducing the need for intubation both in the delivery room and at 6 hours of life. Further prospective studies are warranted. Key Points The International Liaison Committee on Resuscitation recommends multiple interface options for neonatal resuscitation. Vermont Oxford Network endorses nasal interface for premature infants. Binasal prongs are associated with lower intubation rates. [ABSTRACT FROM AUTHOR]
- Abstract: Copyright of American Journal of Perinatology is the property of Thieme Medical Publishing Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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