New respiratory support system helps reduce delivery room intubation in preemies: JAMA

Sweden: The use of a new respiratory support system versus standard T-piece system with face mask, reduced delivery room intubation in extremely preterm infants, a recent study has found. The new system with low imposed work of breathing and short binasal prongs was found to be safe and feasible. The study findings appear in JAMA Pediatrics. 

The establishment of stable breathing after birth is important for preterm infants. Avoiding face masks and delivering pressure-stable continuous positive airway pressure could be of importance in the delivery room. Considering the importance, Snorri Donaldsson, Department of Neonatology, Karolinska University Hospital, Stockholm, Sweden, and colleagues aimed to determine if the use of a new respiratory support system with low imposed work of breathing and short binasal prongs decrease delivery room intubations or death compared with a standard T-piece system with a face mask.

For this purpose, the researchers conducted an unblinded randomized clinical trial conducted in 7 neonatal intensive care units in 5 European countries from March 2016 to May 2020. The researchers screened mothers threatening preterm delivery before week 28 of gestation. A total of 365 mothers were enrolled, and 250 infants were randomized before birth and 246 liveborn infants were treated. The follow-up period was 72 hours after the intervention. The intervention was providing continuous positive airway pressure for 10 to 30 minutes and positive pressure ventilation, if needed, with the randomized system.