What is effect of Selectively Applying Face Mask Positive Pressure Ventilation in Preterm Infants in Delivery Room?

Recent study compared the effects of selectively applying a face mask only for positive pressure ventilation (PPV) versus routinely applying a face mask for continuous positive airway pressure (CPAP) in preterm infants in the delivery room. The researchers randomized infants born before 32 weeks of gestation into selective or routine groups. The primary outcome was the proportion of infants receiving face mask PPV in the delivery room. The results showed that there was no significant difference in face mask PPV rates between the selective group (64%) and the routine group (52%). This suggests that selectively applying a face mask for PPV only did not result in fewer preterm infants receiving PPV in the delivery room.

Impact of Face Mask Application on Spontaneous Breathing in Preterm Infants

The study sought to address the common practice of applying a face mask for breathing support to preterm infants despite most infants breathing spontaneously at birth. The research aimed to determine if the application of a face mask inhibits spontaneous breathing in newborns, leading to the need for PPV. The findings indicated that the timing and duration of PPV were similar in both groups, regardless of whether the face mask was selectively or routinely applied. The study also highlighted that more infants in the lower gestational age category tended to require PPV in the delivery room, indicating varying responses among infants based on gestational age.

Study Design and Methodologies

Moreover, the study design and methodologies were described in detail, including random assignment, data collection processes, and outcomes measured in the delivery room and neonatal intensive care unit. Exploratory outcomes such as duration of respiratory support, incidence of necrotizing enterocolitis, and abnormalities in cranial ultrasound were also assessed. The study acknowledged limitations such as the single-center design and potential for performance bias due to the lack of blinding of caregivers to group assignment.

Conclusion and Implications

Overall, the study provided valuable insights into the practice of applying face masks for respiratory support in preterm infants at birth. It emphasized the need for further research to better understand the association between mask application and respiratory outcomes in newborns. The detailed description of the study's protocol, outcomes, and limitations contributes to the existing literature on neonatal resuscitation practices and informs future research in this area.

Key Points

- The study compared selectively applying a face mask for positive pressure ventilation (PPV) versus routinely applying a face mask for continuous positive airway pressure (CPAP) in preterm infants born before 32 weeks of gestation.

- There was no significant difference in face mask PPV rates between the selective group (64%) and the routine group (52%), suggesting that selectively applying a face mask for PPV only did not result in fewer preterm infants receiving PPV in the delivery room.

- The impact of face mask application on spontaneous breathing in preterm infants was assessed to determine if applying a face mask inhibits spontaneous breathing, leading to the need for PPV. - Timing and duration of positive pressure ventilation (PPV) were similar in both groups regardless of whether the face mask was selectively or routinely applied.

- Infants in the lower gestational age category tended to require PPV in varying responses suggesting differences based on gestational age.

- The study detailed the methodologies including random assignment, data collection processes, and outcomes measured in the delivery room and neonatal intensive care unit, assessing exploratory outcomes such as duration of respiratory support, incidence of necrotizing enterocolitis, and abnormalities in cranial ultrasound, while acknowledging limitations like the single-center design and potential performance bias due to lack of blinding of caregivers to group assignment.

Reference –

CaitríOna M Ní Chathasaigh et al. (2024). Selective Or ROUTINE Face Mask Application For Breathing Support Of Preterm Infants At Birth: A Randomised Trial.. *Resuscitation*, 110467.https://doi.org/10.1016/j.resuscitation.2024.110467