Prospective, randomized controlled trial to be performed at one center, of term and late preterm infants requiring resuscitation. Prenatal consent will be obtained. At randomization, babies will be resuscitated following Neonatal Resuscitation Program (NRP) guidelines and ventilated using the T-piece resuscitator with either a Face Mask (FM) or Non-inflating supraglottic airway. Video will be collected during resuscitation as well as written documentation. Primary outcome will be time to spontaneous breathing, length of resuscitation, and need for endotracheal intubation.
Mothers who are close to delivery of a term or near term infant with estimated fetal weight of 2500gms will be approached for consent to randomize their infant to resuscitation with mask or non-inflatable supraglottic airway (NISGA) if resuscitation is required. Study personnel in delivery will open sequential envelopes with randomized code to indicate which device is to be used if necessary. The resuscitator will be blinded until determination of need of respiratory support. At that time, the appropriate randomized device (face mask or NISGA) will be handed to the resuscitator for use along with T-Piece resuscitator. Video data capture will be used to record type, length and response to resuscitation. This information will be translated to a database prior to destruction of video.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
at delivery if resuscitation is required infant randomized to NI-SGA or face mask as the interface for positive pressure ventilation.
at delivery - standard airway management per Neonatal Resuscitation Program utilizing face mask.
T-Piece Resuscitator for providing postivie pressure ventilation via face mask or non-inflatable supraglottic airway
University of Oklahoma Health Sciences Center
Oklahoma City, Oklahoma, United States
Time to Spontaneous Breathing
Record of time from beginning of resuscitation to time of spontaneous breathing
Time frame: 30 minutes
Duration of Positive Pressure Ventilation
Total time of positive pressure ventilation required to adequate spontaneous breathing.
Time frame: 30 minutes
Need for subsequent endotracheal intubation
Failure of non-invasive resuscitative efforts by face mask or NI-SGA requiring intubation per NRP guideline.
Time frame: 30 minutes
Time needed for NI-SGA placement
Time needed adequate placement of non-inflatable supraglottic airway
Time frame: 1 minute
Need for drugs in resuscitation
Drug administration as part of the standard neonatal resuscitation per NRP
Time frame: 30 minutes
Use of Chest Compressions
Need for chest compressions as part of neonatal resuscitation per NRP guidelines
Time frame: 30 minutes
Use of oxygen
Amount and duration of oxygen use in resuscitation
Time frame: 30 minutes
Rate of complications associated with resuscitation
Presence of complications including bleeding, abdominal distension, laryngeal stridor
Time frame: 30 minutes
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Heart rate 2 minutes after initiation of resuscitation
Heart rate assessed at 2 minutes
Time frame: 2 minutes
Maximum inspiratory pressure
Record of highest peak inspiratory pressure used in resuscitation
Time frame: 30 minutes