title: A Randomized Controlled Trial of End-Tidal Carbon Dioxide Detection of Preterm Infants in the Delivery Room.
abstract: OBJECTIVE
  To compare the ability of qualitative versus quantitative methods of end-tidal carbon dioxide (EtCO2) detection to maintain normocarbia during face mask ventilation (FMV) of preterm infants (<32 weeks) in the delivery room.
  
  
  METHODS
  Preterm infants <32 weeks were randomly assigned to the use of a disposable PediCap EtCO2detector (Covidien, Dublin, Ireland) (qualitative) or a Microstream side stream capnography device (Covidien) (quantitative) for FMV in the delivery room, via a NeoPuff T-piece resuscitator (Fisher and Paykel, Auckland, New Zealand). The primary outcome was the presence of normocarbia, based on partial pressure of CO2(PaCO2) readings obtained in the neonatal intensive care unit within an hour of birth. Normocarbia was defined as a PaCO2measure between 37.5 and 60 mm Hg (5-8 kPa).
  
  
  RESULTS
  Of the 59 infants included, 59% (35/59) were within the PaCO2target range within an hour of birth. There was no difference in the primary outcome; 64% (21/33) of infants in the quantitative group were within the PaCO2range compared with 54% (14/26) in the qualitative group (P = .594); and 93% of participants <28 weeks' gestation were within the PaCO2normocarbic range (90% [9/10] in quantitative group and 100% [5/5] in the qualitative group [P = 1]). There was no difference in the intubation rate, days of ventilation, or bronchopulmonary dysplasia rates between the 2 groups.
  
  
  CONCLUSIONS
  Quantitative or qualitative EtCO2detection methods are both feasible for FMV in the delivery room. Although there was no difference in the incidence of normocarbia, the use of either form of EtCO2monitoring should be considered during newborn stabilization, especially in infants less than 28 weeks' gestation.
  
  
  BACKGROUND
  ISRCTN: ISRCTN10934870.
authors.affiliation: Department of Pediatrics and Child Health, Neonatal Intensive Care Unit, Wilton, Cork, Ireland; Irish Center for Fetal and Neonatal Translational Research (INFANT), University College Cork, Cork, Ireland.
authors.forename: Gavin A
authors.initials: GA
authors.lastname: Hawkes
authors.affiliation: Department of Pediatrics and Child Health, Neonatal Intensive Care Unit, Wilton, Cork, Ireland; Irish Center for Fetal and Neonatal Translational Research (INFANT), University College Cork, Cork, Ireland.
authors.forename: Daragh
authors.initials: D
authors.lastname: Finn
authors.affiliation: Department of Pediatrics and Child Health, Neonatal Intensive Care Unit, Wilton, Cork, Ireland; Irish Center for Fetal and Neonatal Translational Research (INFANT), University College Cork, Cork, Ireland.
authors.forename: Mmoloki
authors.initials: M
authors.lastname: Kenosi
authors.affiliation: Department of Pediatrics and Child Health, Neonatal Intensive Care Unit, Wilton, Cork, Ireland; Irish Center for Fetal and Neonatal Translational Research (INFANT), University College Cork, Cork, Ireland.
authors.forename: Vicki
authors.initials: V
authors.lastname: Livingstone
authors.affiliation: Department of Pediatrics and Child Health, Neonatal Intensive Care Unit, Wilton, Cork, Ireland; Irish Center for Fetal and Neonatal Translational Research (INFANT), University College Cork, Cork, Ireland.
authors.forename: John M
authors.initials: JM
authors.lastname: O'Toole
authors.affiliation: Department of Pediatrics and Child Health, Neonatal Intensive Care Unit, Wilton, Cork, Ireland; Irish Center for Fetal and Neonatal Translational Research (INFANT), University College Cork, Cork, Ireland.
authors.forename: Geraldine B
authors.initials: GB
authors.lastname: Boylan
authors.affiliation: Department of Physiology, School of Medicine, University College Cork, Cork, Ireland.
authors.forename: Ken D
authors.initials: KD
authors.lastname: O'Halloran
authors.affiliation: Department of Pediatrics and Child Health, Neonatal Intensive Care Unit, Wilton, Cork, Ireland; Irish Center for Fetal and Neonatal Translational Research (INFANT), University College Cork, Cork, Ireland.
authors.forename: Anthony C
authors.initials: AC
authors.lastname: Ryan
authors.affiliation: Department of Pediatrics and Child Health, Neonatal Intensive Care Unit, Wilton, Cork, Ireland; Irish Center for Fetal and Neonatal Translational Research (INFANT), University College Cork, Cork, Ireland. Electronic address: gene.dempsey@hse.ie.
authors.forename: Eugene M
authors.initials: EM
authors.lastname: Dempsey
mesh_terms: D019296:Capnography / Q000379:methods*; D002245:Carbon Dioxide / Q000032:analysis*; D003696:Delivery Rooms; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007363:Intensive Care Units, Neonatal; D007494:Ireland; D008297:Male; D008397:Masks; D011446:Prospective Studies; D012121:Respiration, Artificial / Q000379:methods*
chemical_list: D002245:Carbon Dioxide
keywords: carbon dioxide; delivery room; facemask ventilation; stabilization