A randomized trial of oropharyngeal airways to assist stabilization of preterm infants in the delivery room

Versorgung und Reanimation des Neugeborenen nach der Geburt

“…Für Neugeborene nach der Geburt existieren solche Studien bisher nicht. In einer randomisierten Studie mit 137 Frühgeborenen, in der der Gasfluss über eine Beatmungsmaske unter Beatmung gemessen wurde, beeinträchtigte ein Guedel-Tubus die Beatmung häufiger, als wenn kein Guedel-Tubus verwendet wurde (81 % vs. 64 %; p = 0,03; teilweise 70 % vs. 54 %; p = 0,04) [ 152 ]. Nichtsdestotrotz kann ein Guedel-Tubus, da durch ihn die Zunge von den posterioren Atemwegen angehoben wird und der Atemweg so geöffnet wird, eine Beatmung erleichtern, wenn eine Beatmung erschwert ist und sich allein durch z.…”

Delivery Room Management of Asphyxiated Term and Near-Term Infants

“…The European Neonatal Resuscitation guidelines recommend an oropharyngeal airway during their structured approach for escalation of care [19]. Kamlin et al [62] randomized 137 infants <34 weeks’ gestational age to either mask PPV alone or in combination with an appropriately sized oropharyngeal airway. Overall, obstructed inflations and partial obstruction were more frequently observed in infants stabilized with an oropharyngeal airway (81 vs. 64%, p = 0.03, and 70 vs. 54%, p = 0.04), respectively [62].…”

“…Kamlin et al [62] randomized 137 infants <34 weeks’ gestational age to either mask PPV alone or in combination with an appropriately sized oropharyngeal airway. Overall, obstructed inflations and partial obstruction were more frequently observed in infants stabilized with an oropharyngeal airway (81 vs. 64%, p = 0.03, and 70 vs. 54%, p = 0.04), respectively [62]. The trial included infants <34 weeks’ gestation only, which makes translation to term babies difficult.…”

Key paediatric messages from the 2016 European Respiratory Society International Congress

“…These observations support the concern that during preterm resuscitation too low an initial inflation pressure may delay pulmonary transition and indeed high initial pressures may be beneficial when supporting fetal-to-neonatal transition. Also investigating the initial respiratory support, K amlin et al [ 16 ] examined optimising neonatal resuscitation in the delivery room by use of an Guedel oropharyngeal airway (OPA) in infants aged <34 weeks gestation. The assumption was that use of an OPA reduces airway obstruction, facilitates improved ventilation and improves clinical outcomes.…”

“…Infants were studied in a two centre randomised controlled trial (RCT) and, following randomisation, managed using standard national guidelines and randomised to face mask (control) or mask plus OPA (intervention) positive pressure ventilation (PPV) provided by a T-piece resuscitator. Using a physiological data acquisition set to measure the incidence of complete (no gas flow) and partial airway obstruction, the authors reported that face mask obstruction was common during PPV and use of OPAs was associated with significantly higher rates of partial obstruction [ 16 ]. Working in the same environment ( i.e.…”