Oxygenation with T-piece versus self-inflating bag for ventilation of extremely preterm infants at birth: a randomized controlled trial.
OBJECTIVE
To investigate whether infants < 29 weeks gestation who receive positive pressure ventilation (PPV) immediately after birth with a T-piece have higher oxygen saturation (SpO₂) measurements at 5 minutes than infants ventilated with a self inflating bag (SIB).


METHODS
Randomized, controlled trial of T-piece or SIB ventilation in which SpO₂ was recorded immediately after birth from the right hand/wrist with a Masimo Radical pulse oximeter, set at 2-second averaging and maximum sensitivity. All resuscitations started with air.


RESULTS
Forty-one infants received PPV with a T-piece and 39 infants received PPV with a SIB. At 5 minutes after birth, there was no significant difference between the median (interquartile range) SpO₂ in the T-piece and SIB groups (61% [13% to 72%] versus 55% [42% to 67%]; P = .27). More infants in the T-piece group received oxygen during delivery room resuscitation (41 [100%] versus 35 [90%], P = .04). There was no difference in the groups in the use of continuous positive airway pressure, endotracheal intubation, or administration of surfactant in the delivery room.


CONCLUSIONS
There was no significant difference in SpO₂ at 5 minutes after birth in infants < 29 weeks gestation given PPV with a T-piece or a SIB as used in this study.
Newborn Services, The Royal Women's Hospital, Melbourne, Australia. jennifer.dawson@thewomens.org.au
Jennifer A
JA
Dawson
Georg M
GM
Schmölzer
C Omar F
CO
Kamlin
Arjan B
AB
Te Pas
Colm P F
CP
O'Donnell
Susan M
SM
Donath
Peter G
PG
Davis
Colin J
CJ
Morley
D004867:Equipment Design; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007327:Insufflation / Q000295:instrumentation; D007442:Intubation, Intratracheal / Q000295:instrumentation; D008297:Male; D009359:Neonatology; D010092:Oximetry / Q000379:methods; D010100:Oxygen / Q000737:chemistry*; D011175:Positive-Pressure Respiration / Q000295:instrumentation* / Q000379:methods; D012127:Respiratory Distress Syndrome, Newborn / Q000628:therapy*; D013501:Surface-Active Agents / Q000627:therapeutic use
D013501:Surface-Active Agents; D010100:Oxygen