title: ELBW infants: to intubate or not to intubate in the delivery room?
abstract: Few years ago, elective tracheal intubation in the delivery room was considered as the routine approach in managing respiratory failure in extremely-low-birth-weight infants (ELBW), at least in terms of surfactant administration. Over recent years, the indications and principles of neonatal resuscitation of ELBW infants have been partially reviewed: many randomized clinical trials (RCT) have demonstrated that these infants do not die quickly without intubation in the delivery room, and many infants only need a little help in completing foetal-neonatal transition through the use of lung recruitment manoeuvres in the delivery room (e.g. sustained lung inflation, CPAP) and then only non-invasive ventilation support. Tracheal intubation and mechanical ventilation can be reserved solely for depressed or ELBW, although further RCTs are needed to provide additional information and to provide a conclusive response to the eternal debate as to whether intubation at birth can influence outcome for ELBW infants.
authors.affiliation: NICU, V.Buzzi Children's Hospital, ICP, Milan, Italy. g.lista@icp.mi.it
authors.forename: G
authors.initials: G
authors.lastname: Lista
authors.forename: P
authors.initials: P
authors.lastname: Fontana
authors.forename: F
authors.initials: F
authors.lastname: Castoldi
authors.forename: F
authors.initials: F
authors.lastname: Cavigioli
authors.forename: S
authors.initials: S
authors.lastname: Bianchi
authors.forename: P
authors.initials: P
authors.lastname: Bastrenta
mesh_terms: D045422:Continuous Positive Airway Pressure / Q000379:methods / Q000706:statistics & numerical data; D003696:Delivery Rooms; D006801:Humans; D052577:Infant, Extremely Low Birth Weight / Q000502:physiology; D007231:Infant, Newborn; D007442:Intubation, Intratracheal / Q000706:statistics & numerical data*; D012121:Respiration, Artificial / Q000379:methods / Q000706:statistics & numerical data; D012127:Respiratory Distress Syndrome, Newborn / Q000628:therapy*; D012151:Resuscitation / Q000379:methods