title: Pulmonary air leak associated with CPAP at term birth resuscitation.
abstract: OBJECTIVE
  The Japan Resuscitation Council (JRC) Guidelines 2010 for neonatal resuscitation introduced continuous positive airway pressure (CPAP) in delivery room. The present study evaluated the effect of CPAP for pulmonary air leak at term birth.
  
  
  METHODS
  This retrospective single-centre study used the data of term neonates who were born without major congenital anomalies at our centre between 2008 and 2009, and between 2011 and 2012.
  
  
  METHODS
  Resuscitation according to the JRC Guidelines 2010.
  
  
  METHODS
  We examined the association between the JRC Guidelines 2010, CPAP by face mask and pulmonary air leak.
  
  
  RESULTS
  A total of 5038 infants were analysed. The frequency of CPAP by face mask increased after the update of the JRC Guidelines in 2010 (1.7% vs 11.1%; p<0.001). Pulmonary air leak increased at early term (37 weeks: 1.0% vs 3.5%, p=0.02; 38 weeks: 0.7% vs 2.2%, p=0.02). While adjusting for confounders, the JRC Guidelines 2010 was associated with pulmonary air leak in early-term neonates (37 weeks: adjusted OR (aOR) 4.37; 95% CI 1.40 to 17.45; 38 weeks: aOR 2.80; 95% CI 1.04 to 8.91), but this association disappeared while adjusting for face mask CPAP additionally (37 weeks: aOR 1.90; 95% CI 0.47 to 8.71; 38 weeks: aOR 1.66; 95% CI 0.54 to 5.77).
  
  
  CONCLUSIONS
  Following the update of the JRC guidelines on neonatal resuscitation, we observed an increased use of CPAP via face mask, which was associated with a higher prevalence of pulmonary air leak in early-term neonates in our centre.
authors: Division of Neonatology, Center of Maternal-Fetal, Neonatal and Reproductive Medicine, National Center for Child Health and Development, Tokyo, Japan.
authors: Kenji
authors: K
authors: Hishikawa
authors: Division of Neonatology, Center of Maternal-Fetal, Neonatal and Reproductive Medicine, National Center for Child Health and Development, Tokyo, Japan.
authors: Keiji
authors: K
authors: Goishi
authors: Department of Developmental Social Medicine, National Research Institute for Child Health and Development, Tokyo, Japan.
authors: Takeo
authors: T
authors: Fujiwara
authors: Division of Neonatology, Center of Maternal-Fetal, Neonatal and Reproductive Medicine, National Center for Child Health and Development, Tokyo, Japan.
authors: Masao
authors: M
authors: Kaneshige
authors: Division of Neonatology, Center of Maternal-Fetal, Neonatal and Reproductive Medicine, National Center for Child Health and Development, Tokyo, Japan.
authors: Yushi
authors: Y
authors: Ito
authors: Center of Maternal-Fetal, Neonatal and Reproductive Medicine, National Center for Child Health and Development, Tokyo, Japan.
authors: Haruhiko
authors: H
authors: Sago
mesh_terms: D045422:Continuous Positive Airway Pressure / Q000009:adverse effects* / Q000379:methods; D005865:Gestational Age; D019983:Guideline Adherence; D006801:Humans; D007231:Infant, Newborn; D008397:Masks; D008478:Mediastinal Emphysema / Q000209:etiology*; D011030:Pneumothorax / Q000209:etiology*; D017410:Practice Guidelines as Topic; D012189:Retrospective Studies
keywords: continuous positive airway pressure; neonatal cardiopulmonary resuscitation; neonatal pneumothorax; pulmonary air leak; term newborn