Selective or routine face mask application for breathing support of preterm infants at birth: a randomised trial.

IF 6.5 1区医学 Q1 CRITICAL CARE MEDICINE

Resuscitation Pub Date : 2025-01-01 Epub Date: 2024-12-17 DOI:10.1016/j.resuscitation.2024.110467

Caitríona M Ní Chathasaigh, Emma A Dunne, Lucy E Geraghty, Madeleine C Murphy, Eoin O'Currain, Lisa K McCarthy, Colm P F O'Donnell

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引用次数: 0

Abstract

Background: Most preterm infants breathe spontaneously at birth. Despite this, the majority have a face mask immediately applied for breathing support. Face mask application may inhibit spontaneous breathing in newborn infants. We wished to determine whether selectively applying a mask to give positive pressure ventilation (PPV) for apnoea or bradycardia only compared to routinely applying a mask for continuous positive airway pressure (CPAP) resulted in fewer preterm infants receiving PPV in the delivery room (DR).

Methods: Infants born before 32 weeks of gestation were randomly assigned to either SELECTIVE or ROUTINE groups, stratified by gestational age (GA) [<28 and 28-31 weeks]. Infants in the SELECTIVE group were placed supine to breathe spontaneously and were not to receive mask CPAP before five minutes of life. Infants in the ROUTINE group received face mask CPAP as soon as possible after birth. Infants in both groups received mask PPV for apnoea or bradycardia. The primary outcome was face mask PPV in the DR.

Results: Of the 201 who were randomly assigned, we analysed data for 200 infants: 98 in the SELECTIVE group [mean (SD) GA: 28 (3) weeks; birth weight (BW): 1120 (439)g] and 102 in the ROUTINE group [mean (SD) GA: 28 (2) weeks; BW: 1150 (425)g]. PPV rates in the DR were similar between groups [SELECTIVE 63/98 (64 %) versus ROUTINE 53/102 (52 %); RR 1.24, 95 %CI 0.98-1.57, p = 0.08].

Conclusion: Selectively applying a face mask for PPV only did not result in fewer preterm infants receiving PPV in the DR.

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选择性或常规面罩应用于早产儿出生时的呼吸支持：一项随机试验。

背景：大多数早产儿在出生时自主呼吸。尽管如此，大多数人还是会立即戴上口罩来支持呼吸。使用口罩可能会抑制新生儿的自主呼吸。我们希望确定是否选择性地使用面罩进行呼吸暂停或心动过缓的正压通气（PPV）与常规使用面罩进行持续气道正压通气（CPAP）相比，会减少在产房（DR）接受PPV的早产儿。方法：在32 孕周之前出生的婴儿随机分为选择性组或常规组，按胎龄（GA）分层[结果：在随机分配的201例婴儿中，我们分析了200例婴儿的数据：选择性组98例[平均（SD） GA: 28(3)周；出生体重（BW）： 1120 (439)g)和102（常规组）[平均（SD） GA: 28(2)周；生物谷：1150 (425)g]。两组之间DR的PPV率相似[选择性63/98（64 %）与常规53/102(52 %)；RR 1.24, 95 %CI 0.98-1.57, p = 0.08]。结论：选择性地使用口罩进行PPV治疗并不能减少DR早产儿的PPV发生率。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Resuscitation 医学-急救医学

CiteScore

12.00

自引率

18.50%

发文量

556

审稿时长

21 days

期刊介绍： Resuscitation is a monthly international and interdisciplinary medical journal. The papers published deal with the aetiology, pathophysiology and prevention of cardiac arrest, resuscitation training, clinical resuscitation, and experimental resuscitation research, although papers relating to animal studies will be published only if they are of exceptional interest and related directly to clinical cardiopulmonary resuscitation. Papers relating to trauma are published occasionally but the majority of these concern traumatic cardiac arrest.