title: A review of carbon dioxide monitoring in preterm newborns in the delivery room.
abstract: BACKGROUND
  The physiologic adaptation to extra uterine life during the immediate neonatal period is unique. Many newborns require assistance in this adaptive process. Recent evidence now supports titrating oxygen to guide resuscitation but no guidance is provided on utilizing exhaled CO2 measurements.
  
  
  OBJECTIVE
  To review the current evidence relating to the use of CO2 monitoring in preterm newborns in the delivery room.
  
  
  METHODS
  Search was performed using the Cochrane Central Register of Controlled Trials, MEDLINE (1966-2014) and PREMEDLINE, EMBASE (1980-2014), CINAHL (1982-2014), Web of Science (1975-2014) and the Oxford Database of Perinatal Trials.
  
  
  RESULTS
  The search revealed 21 articles relating to CO2 detection, either quantitative or qualitative, in the newborn infant. The majority of these were observational studies, eight relating to CO2 detection as a means of confirming correct endotracheal tube placement in the newborn infant. The other indication is for mask ventilation, and there is one randomized control trial and four observational studies of CO2 detection during mask ventilation. The overall recommendation for CO2 detection for both clinical uses in the delivery suite is level B.
  
  
  CONCLUSIONS
  CO2 detection may be of particular benefit for preterm infants in the delivery suite. However there is a need for further research into CO2 detection, in particular capnography, as a means of confirming effective PPV in neonatal resuscitation.
authors.affiliation: Department of Neonatology, Cork University Maternity Hospital, Ireland; Department of Paediatrics and Child Health, University College Cork, Ireland; Irish Centre for Fetal and Neonatal Translational Research (INFANT), Cork University Maternity Hospital, Wilton, Co. Cork, Ireland.
authors.forename: G A
authors.initials: GA
authors.lastname: Hawkes
authors.affiliation: Department of Neonatology, University Maternity Hospital Limerick, Ireland.
authors.forename: J
authors.initials: J
authors.lastname: Kelleher
authors.affiliation: Department of Neonatology, Cork University Maternity Hospital, Ireland; Department of Paediatrics and Child Health, University College Cork, Ireland.
authors.forename: C A
authors.initials: CA
authors.lastname: Ryan
authors.affiliation: Department of Neonatology, Cork University Maternity Hospital, Ireland; Department of Paediatrics and Child Health, University College Cork, Ireland; Irish Centre for Fetal and Neonatal Translational Research (INFANT), Cork University Maternity Hospital, Wilton, Co. Cork, Ireland. Electronic address: gene.dempsey@hse.ie.
authors.forename: E M
authors.initials: EM
authors.lastname: Dempsey
mesh_terms: D019296:Capnography; D003696:Delivery Rooms; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D008991:Monitoring, Physiologic / Q000379:methods*
keywords: CO(2) detector; Capnography; End tidal carbon dioxide; Neonatal Resuscitation