The aim of the study is to compare the non-inferiority of the Mix-safe T-piece resuscitator (intervention group) to the Neopuff T-piece resuscitator (control group) in providing respiratory assistance during the resuscitation of newborns. If Mix-safe is proven to be non-inferior, the study intends to support its distribution to healthcare facilities that handle delivery and neonatal resuscitation.
Delivery and the transition from intrauterine to extrauterine life involve the respiratory transition from the placenta to the lungs. Most neonates breathe spontaneously at birth, but 10% require stimulation, and 1% need positive pressure ventilation. Respiratory disturbances in newborns require proper management because they contribute to high morbidity and mortality rates. The T-piece resuscitator is a commonly used modality for respiratory support. Mix-safe® (Fyrom) is a T-piece resuscitator with an internal compressor developed in Indonesia, offering cost-effective and precise oxygen mixing without the need for compressed air. As of now, there have been no studies examining the non-inferiority status of Mix-safe compared to standard TPR. If proven non-inferior, this device should be distributed across healthcare facilities handling delivery and neonatal resuscitation. This research is a randomized controlled trial, a non-inferiority trial comparing Mix-safe® (treatment group) with NeopuffTM (control group) in providing respiratory assistance during the resuscitation process of newborns. The study is conducted in the Perinatology unit of Cipto Mangunkusumo National Hospital.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
SUPPORTIVE_CARE
Masking
NONE
Enrollment
107
Compressor based T piece resuscitator
Standardized T piece resuscitator
RSUPN Cipto Mangunkusumo
Jakarta Pusat, DKI Jakarta, Indonesia
Oxygen saturation at five minute of life
Oxygen saturation (in percentage)
Time frame: from birth until the 5th minutes
Time to achieve peripheral oxygen saturation at 80%
Time to achieve peripheral oxygen saturation at 80%
Time frame: from birth until oxygen saturation at 80% or until 10 minutes of life, whichever comes first
Heart rate at five minutes of life
Heart rate at five minutes of life
Time frame: From birth until five minutes of life
Oxygen fraction at five minutes of life
Oxygen fraction at five minutes of life
Time frame: From birth until five minutes of life.
Time to achieve HR > 100x/min
Time to achieve heart rate more than 100 beat per minute.
Time frame: From birth until 10 minutes of life
Maximum FiO2
Maximum oxygen fraction during resuscitation
Time frame: From birth until 10 minutes of life.
APGAR at five minutes
APGAR score at five minutes of life.
Time frame: From birth until five minutes of life
Duration of CPAP
Duration of CPAP used in the delivery room, measured in minutes
Time frame: From birth until ten minutes of life
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Duration of PPV
Duration of PPV used in the delivery room, measured in minutes
Time frame: From birth until ten minutes of life
Intubation
Intubation at delivery room
Time frame: From birth until ten minutes of life
Need for surfactant
Administration of surfactant during hospitalization
Time frame: From birth until discharged or death, whichever comes first, maximum followed up to 120 days.
Need for methylxanthine
Administration of methylxanthine during hospitalization
Time frame: From birth until discharged or death, whichever comes first, followed up to 120 days
Length of stay
Duration of hospitalization among surviving patients
Time frame: From birth until dishcarged or followed up to 120 days, whichever comes first
Intraventricular Hemorrhage
Bleeding into the brain's ventricular system in preterm infants, graded I-IV by severity on cranial ultrasound or neuroimaging.
Time frame: From birth until death or discharged, whichever comes first, followed up to 120 days
Periventricular Leukomalacia
White matter brain injury near the ventricles due to ischemia or inflammation, associated with later neurodevelopmental impairment. Grading from I to IV on USG or neuroimaging.
Time frame: From birth until death, discharged, whichever comes first, followed up to 120 days
Retinopathy of Prematurity
Abnormal retinal vascular development in preterm infants that may progress to retinal detachment and visual impairment if severe. Grade I to IV
Time frame: From birth until death or discharged, whichever comes first, followed up to 120 days.