title: T-piece resuscitator versus self-inflating bag for preterm resuscitation: an institutional experience.
abstract: BACKGROUND
  Manual ventilation in the delivery room is provided with devices such as self-inflating bags (SIBs), flow-inflating bags, and T-piece resuscitators.
  
  
  OBJECTIVE
  To compare the effect of type of manual ventilation device on overall response to resuscitation among preterm neonates born at < 35 weeks gestation.
  
  
  METHODS
  Retrospective data were collected in 2 time periods. Primary outcome was overall response to resuscitation, as measured by Apgar score. Secondary outcomes were incidence of air leaks, need for chest compressions/epinephrine, need for intubation, and surfactant use.
  
  
  RESULTS
  We identified 294 resuscitations requiring ventilation. SIB was used for 135 neonates, and T-piece was used for 159 neonates. There was no significant difference between the 1-min and 5-min Apgar scores between SIB and T-piece (P = .77 and P = .11, respectively), nor were there significant differences in secondary outcomes. The rate of rise of Apgar score was higher, by 0.47, with T-piece, compared to SIB (95% CI 0.08-0.87, P = .02).
  
  
  CONCLUSIONS
  Although some manikin studies favor T-piece for providing reliable and consistent pressures, our experience did not indicate significant differences in effectiveness of resuscitation between the T-piece and SIB in preterm resuscitations.
authors.affiliation: Division of Neonatal-Perinatal Medicine, Children's Hospital of Richmond, Virginia Commonwealth University, Richmond, VA 23298-0276, USA
authors.forename: Archana
authors.initials: A
authors.lastname: Jayaram
authors.forename: Adam
authors.initials: A
authors.lastname: Sima
authors.forename: Gail
authors.initials: G
authors.lastname: Barker
authors.forename: Leroy R
authors.initials: LR
authors.lastname: Thacker
mesh_terms: D001034:Apgar Score; D001993:Bronchodilator Agents / Q000627:therapeutic use; D057186:Comparative Effectiveness Research; D004837:Epinephrine / Q000627:therapeutic use; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007442:Intubation, Intratracheal / Q000706:statistics & numerical data; D008297:Male; D008991:Monitoring, Physiologic; D063087:Noninvasive Ventilation / Q000009:adverse effects / Q000379:methods / Q000706:statistics & numerical data; D017063:Outcome Assessment, Health Care; D012151:Resuscitation / Q000009:adverse effects / Q000379:methods / Q000706:statistics & numerical data; D012189:Retrospective Studies; D055397:Ventilator-Induced Lung Injury / Q000517:prevention & control; D012122:Ventilators, Mechanical
chemical_list: D001993:Bronchodilator Agents; D004837:Epinephrine