T-piece resuscitator versus self-inflating bag for resuscitation in the delivery room in preterm neonates: a randomised controlled trial.
Archives of Disease in Childhood: Fetal and Neonatal Edition · 2025-05-03 · Randomised trial
Abstract
OBJECTIVE: To compare the efficacy of T-piece resuscitator (TPR) and self-inflating bag (SIB) for resuscitation of preterm neonates in the delivery room. SETTINGS: Level III neonatal intensive care unit in North India. DESIGN: Open-label, parallel-group, randomised controlled trial. PATIENT: Preterm neonates of>26-34 weeks of gestation requiring positive pressure ventilation (PPV) at birth. INTERVENTION: Neonates needing PPV at birth were identified using Neonatal Resuscitation Programme guidelines, 2020, and resuscitated using either TPR or SIB as per permuted block random sequence. MAIN OUTCOME MEASURES: Primary outcome was need for delivery room endotracheal intubation. Secondary outcomes were duration of PPV, oxygen saturation (SpO2) at 2 and 5 min, time to spontaneous respiration and heart rate>100 beats per minute. RESULTS: Mean gestation age (weeks; 30±2.1 vs 31±2) and birth weight (g; 1400±408 vs 1450±427) were comparable. Of the total 120, 8 (13.7%) in the TPR group versus 19 (30.6%) neonates in the SIB group were intubated in the delivery room (risk difference (95% CI), -0.16 (-0.31 to -0.02); p=0.03). SpO2 mean (SD) at 5 min in TPR group and SIB group were 82.9±8.7% and 78.9±12.1%, respectively; mean difference (95% CI), 3.99 (0.15 to 7.83); p=0.04). Median (IQR) of combined Apgar at 5 min in TPR group and SIB group were 13 (12-14) and 12 (10-13), p 0.02. Other outcomes were comparable. CONCLUSION: TPR is more efficacious than SIB in terms of lesser delivery room intubation and better SpO2 at 5 min in preterm neonates.
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Tags
Bag-valve-mask ventilation · Neonates
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