Ventilator Lung; Newborn
Conditions
Brief summary
Although the majority of premature neonates \< 30 weeks gestion require positive pressure ventilation (PPV) at birth, the optimal interface to provide PPV has not been determined. Preferably this support would be provided by non-invasive means to prevent the development of bronchopulmonary dysplasia. Resuscitation with a face mask, single nasal tube, nasal prongs, and/or LMA are all approved methods of resuscitation per NRP as of 2010. Face masks have been associated with more dead space, air leak and airway obstruction however are the most commonly used interface. Recently, the Trigeminal Cardiac Reflex has been described, which can be induced with the placement of a facemask, resulting in bradycardia and apnea. Bi-nasal prongs (RAM cannula) have been found in studies to be associated with lower intubation rates in the delivery room (down to 24 weeks gestation), less need for epinephrine, chest compressions, and subsequent invasive ventilation. In addition to the potential practical advantages of bi-nasal prong resuscitation, there is evidence to suggest that ventilation through the nose may stimulate the subepithelial receptors of the upper airways causing an increase in respiratory rate and depth.
Interventions
None listed
Sponsors
Children's Hospital of Illinois
OSF Healthcare System
University of Illinois College of Medicine at Peoria
Study design
Observational model
OTHER
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
0 Weeks to 30 Weeks
Healthy volunteers
No
Inclusion criteria
All resuscitated infants \< 30 weeks' gestation born at OSF SFMC
Exclusion criteria
Diagnosis of congenital diaphragmatic hernia No PPV needed, or no resuscitation desired due to major congenital anomalies or peri- viable status
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Comparing Intubation Rates in the Delivery Room by Interface | 3 years | We hypothesize that there will be at least a 40% reduction in the rate of intubation for patients born \< 30 weeks' gestation when bi-nasal prongs are utilized for neonatal resuscitation vs face mask. |
Countries
United States
Contacts
Primary ContactAshley Fischer, MD
Outcome results
None listed