Clinical and Laboratory ObservationCrying and Breathing by Extremely Preterm Infants Immediately After Birth
Section snippets
Methods
Since January 2004, we have studied infants who were anticipated to need resuscitation in the delivery rooms (DR) of the Royal Women's Hospital, Melbourne, Australia, with the permission of the Research and Ethics Committees.10 When available, a member of the investigating team recorded the care given to these infants immediately after birth with a high definition digital video camera. Sound was recorded at all deliveries. The investigator was not involved in the resuscitation. Immediately
Results
Of 156 videos recorded between January 2004 and October 2005, 61 were of eligible infants. The mean (SD) gestational age and weight at birth were 26 (2) weeks and 838 (192) g, respectively. All but 2 infants were exposed to antenatal corticosteroids.
Forty-two (69%) of these infants had an audible cry and visible breathing immediately after birth. A further 7 infants had visible breathing without crying, giving a total of 49 infants who breathed (80%) before any respiratory support was given.
Discussion
In some centers, all extremely preterm infants are intubated soon after birth for surfactant treatment regardless of whether or not they breathe. This was not the policy in our hospital; thus, whether to intubate a preterm infant was a clinical decision. Many infants in our study were intubated though they were breathing and had a heart rate >100 bpm on CPAP. In some cases, the clinicians thought that the infant was too immature to continue to breathe successfully on CPAP; in others, the reason
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Cited by (92)
Alternatives to neonatal intubation
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2022, Paediatric Respiratory ReviewsCitation Excerpt :Future studies with larger numbers of neonates will help to evaluate the outcome nNAVA as a standard care of neonates with RDS when compared to others modes of NIV. NIV can play an important role in the stabilization of the term and preterm infant in the delivery room [18,88]. In the delivery room, ventilatory support is usually provided via face mask placed over the mouth and nose connected to a T-piece resuscitator, a flow inflating resuscitation bag, or a self-inflating device.
Delivery room stabilization and respiratory support
2022, Goldsmith's Assisted Ventilation of the Neonate: An Evidence-Based Approach to Newborn Respiratory Care, Seventh Edition
The authors declare no conflicts of interest.