Until recently, bulb or catheter oronasopharyngeal suctioning (ONPS) of all the infants, including vigorous infants in the delivery room, has been featured as a standard of newborn care. The 5th edition of the Newborn Resuscitation Program (NRP) has minimized the recommendation for routine suctioning of infants following delivery, provided they are not depressed or in need of immediate resuscitation. However, this new alternative recommendation was based on a small randomized trial and other lower level evidence rather than evidence from larger trials. The NRP Textbook cautions against vigorous suctioning because of the resultant apnea or bradycardia. Furthermore, suctioning may delay other more important steps of resuscitation. Thus, it is necessary to compare the alternative recommended practice, i.e. simple wiping of the mouth, to determine if it has equivalent efficacy and a favorable side effect profile compared to suctioning.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
506
Bulb suctioning of the mouth then the nose immediately following delivery
Gentle wiping of mouth then nose with a soft cloth immediately following delivery
University of Alabama at Birmingham
Birmingham, Alabama, United States
Mean respiratory rate over the first 24 hours of life
Respiratory rates measured every 8 hours during the first 24 hours after birth
Time frame: 24 hours after birth
Apgar Scores at one minute of age
Independent assignment of Apgar Scores at one minute of age
Time frame: 1 minute of age
Number of newborns with tachypnea
Number of newborns with tachypnea as defined by respiratory rate greater than 60 breaths per minute
Time frame: 24 hours
Need for delivery room resuscitation
Need for delivery room resuscitation including suctioning, intubation, positive pressure ventilation, chest compressions, and/or medication
Time frame: 1 hour after birth
Admission to the Neonatal Intensive Care Unit
Needing admission to the Neonatal Intensive Care Unit
Time frame: 1 hour after birth
Oxygen saturations prior to discharge from hospital
Measurements of oxygen saturations in the well baby nursery prior to discharge home
Time frame: 5 days of age
Apgar score at 5 minutes of age
Independent assignment of Apgar score at 5 minutes of age
Time frame: 5 minutes of age
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