title: T-piece or self inflating bag for positive pressure ventilation during delivery room resuscitation: an RCT.
abstract: OBJECTIVE
  To compare the duration of positive pressure ventilation (PPV) during delivery room resuscitation in neonates resuscitated with self-inflating bag (SIB) and T-piece resuscitator (TPR).
  
  
  METHODS
  Randomized control trial.
  
  
  METHODS
  Delivery room and neonatal intensive care unit of a tertiary care center in northern India.
  
  
  METHODS
  Consecutively born neonates more than 26 weeks of gestation requiring PPV at birth.
  
  
  METHODS
  Eligible neonates were randomized to two groups, SIB and TPR.
  
  
  METHODS
  Duration of PPV, intubation rates in delivery room, incidence of respiratory distress, need for mechanical ventilation during first 48h and its duration, need for surfactant replacement therapy and mortality during NICU stay.
  
  
  RESULTS
  Fifty neonates received PPV with a SIB and 40 received PPV with a TPR. The mean (SD) birth weight and gestational age of neonates in SIB and TPR groups were 2264 (872) and 2065 (814)g; 35.1 (3.6) and 34.3 (3.7) weeks, respectively. The median (IQR) duration of PPV in delivery room was significantly less in TPR group as compared to SIB; 30 (30-60)s vs. 60 (30-90)s, respectively; (p<0.001). A higher proportion of neonates required delivery room intubation in SIB group as compared to TPR group (34% vs. 15%, p=0.04). In the TPR group, a higher proportion of neonates could be resuscitated with room air only (72.5% vs. 38%, p=0.001). Other outcomes were comparable in the two groups. Similar findings were observed in neonates <34 weeks, except that fewer neonates resuscitated with TPR required invasive ventilation (31.6% vs. 77.8%, p=0.008).
  
  
  CONCLUSIONS
  Use of TPR during delivery room resuscitation resulted in shorter duration of PPV and lesser rates of intubation as compared to SIB. More infants in this group could be resuscitated with room air only (CTRI/2010/091/002946).
authors: Department of Neonatology, Institute of Child health, Sir Ganga Ram Hospital, Rajinder Nagar, New Delhi 110060, India.
authors: Anup
authors: A
authors: Thakur
authors: Department of Neonatology, Institute of Child health, Sir Ganga Ram Hospital, Rajinder Nagar, New Delhi 110060, India. Electronic address: satishsaluja@gmail.com.
authors: Satish
authors: S
authors: Saluja
authors: Department of Neonatology, Institute of Child health, Sir Ganga Ram Hospital, Rajinder Nagar, New Delhi 110060, India.
authors: Manoj
authors: M
authors: Modi
authors: Department of Neonatology, Institute of Child health, Sir Ganga Ram Hospital, Rajinder Nagar, New Delhi 110060, India.
authors: Neelam
authors: N
authors: Kler
authors: Department of Neonatology, Institute of Child health, Sir Ganga Ram Hospital, Rajinder Nagar, New Delhi 110060, India.
authors: Pankaj
authors: P
authors: Garg
authors: Department of Neonatology, Institute of Child health, Sir Ganga Ram Hospital, Rajinder Nagar, New Delhi 110060, India.
authors: Arun
authors: A
authors: Soni
authors: Department of Neonatology, Institute of Child health, Sir Ganga Ram Hospital, Rajinder Nagar, New Delhi 110060, India.
authors: Avneet
authors: A
authors: Kaur
authors: Department of Neonatology, Institute of Child health, Sir Ganga Ram Hospital, Rajinder Nagar, New Delhi 110060, India.
authors: Sanjeev
authors: S
authors: Chetri
mesh_terms: D003696:Delivery Rooms; D005260:Female; D006801:Humans; D007194:India; D007231:Infant, Newborn; D007442:Intubation, Intratracheal / Q000706:statistics & numerical data; D008297:Male; D011175:Positive-Pressure Respiration / Q000295:instrumentation* / Q000379:methods; D012127:Respiratory Distress Syndrome, Newborn / Q000628:therapy*; D012151:Resuscitation / Q000295:instrumentation* / Q000379:methods; D013997:Time Factors
keywords: Positive end expiratory pressure; Positive pressure ventilation; Self inflating bag; T piece resuscitator