Corrective steps to enhance ventilation in the delivery room

Archives of Disease in Childhood. Fetal and Neonatal Edition
Kesi C YangElizabeth E Foglia

Abstract

The clinical impact of ventilation corrective steps for delivery room positive pressure ventilation (PPV) is not well studied. We aimed to characterise the performance and effect of ventilation corrective steps (MRSOPA (Mask adjustment, Reposition airway, Suction mouth and nose, Open mouth, Pressure increase and Alternative airway)) during delivery room resuscitation of preterm infants. Prospective observational study of delivery room PPV using video and respiratory function monitor recordings. Tertiary academic delivery hospital. Preterm infants <32 weeks gestation. Mean exhaled tidal volume (Vte) of PPV inflations before and after MRSOPA interventions, categorised as inadequate (<4 mL/kg); appropriate (4-8 mL/kg), or excessive (>8 mL/kg). Secondary outcomes were leak (>30%) and obstruction (Vte <1 mL/kg), and infant heart rate. There were 41 corrective interventions in 30 infants, with a median duration of 15 (IQR 7-29) s. The most frequent intervention was a combination of Mask/Reposition and Suction/Open. Mean Vte was inadequate before 16/41 interventions and became adequate following 6/16. Mean Vte became excessive after 6/41 interventions. Mask leak, present before 13/41 interventions, was unchanged after 4 and resolved a...Continue Reading

References

May 6, 2005·Archives of Disease in Childhood. Fetal and Neonatal Edition·C P F O'DonnellC J Morley
Nov 28, 2007·Archives of Disease in Childhood. Fetal and Neonatal Edition·Fiona E WoodPeter G Davis
Jan 15, 2008·Archives of Disease in Childhood. Fetal and Neonatal Edition·F E WoodP G Davis
Sep 25, 2009·Archives of Disease in Childhood. Fetal and Neonatal Edition·Georg M SchmölzerPeter G Davis
Jun 16, 2010·Archives of Disease in Childhood. Fetal and Neonatal Edition·Georg M SchmölzerPeter G Davis
Jul 2, 2010·Archives of Disease in Childhood. Fetal and Neonatal Edition·Kim SchillemanArjan B te Pas
Sep 9, 2010·The Cochrane Database of Systematic Reviews·Georg M SchmölzerPeter G Davis
Nov 18, 2010·Archives of Disease in Childhood. Fetal and Neonatal Edition·Georg M SchmölzerPeter G Davis
Nov 8, 2011·The Journal of Pediatrics·Georg M SchmölzerPeter G Davis
Aug 9, 2016·Resuscitation·Christiane SkåreTheresa M Olasveengen
Sep 8, 2018·Acta Paediatrica·Keira C KilmartinAnthony C Ryan

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Citations

Dec 11, 2020·Archives of Disease in Childhood. Fetal and Neonatal Edition·Vincent D GaertnerLaila Springer
May 18, 2021·Seminars in Perinatology·John ChuoScott Lorch

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