Higher versus Lower Oxygen Concentration during Respiratory Support in the Delivery Room in Extremely Preterm Infants: A Pilot Feasibility Study

Background: Optimal starting oxygen concentration for delivery room resuscitation of extremely preterm infants (<29 weeks) remains unknown, with recommendations of 21–30% based on uncertain evidence. Individual patient randomized trials designed to answer this question have been hampered by poor...

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Autores principales:	Brenda Hiu Yan Law, Elizabeth Asztalos, Neil N. Finer, Maryna Yaskina, Maximo Vento, William Tarnow-Mordi, Prakesh S. Shah, Georg M. Schmölzer
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	infant newborn delivery room neonatal resuscitation oxygen concentration Pediatrics RJ1-570
Acceso en línea:	https://doaj.org/article/63d501caee234c86a909adea29acc323
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spelling	oai:doaj.org-article:63d501caee234c86a909adea29acc3232021-11-25T17:13:46ZHigher versus Lower Oxygen Concentration during Respiratory Support in the Delivery Room in Extremely Preterm Infants: A Pilot Feasibility Study10.3390/children81109422227-9067https://doaj.org/article/63d501caee234c86a909adea29acc3232021-10-01T00:00:00Zhttps://www.mdpi.com/2227-9067/8/11/942https://doaj.org/toc/2227-9067Background: Optimal starting oxygen concentration for delivery room resuscitation of extremely preterm infants (<29 weeks) remains unknown, with recommendations of 21–30% based on uncertain evidence. Individual patient randomized trials designed to answer this question have been hampered by poor enrolment. Hypothesis: It is feasible to compare 30% vs. 60% starting oxygen for delivery room resuscitation of extremely preterm infants using a change in local hospital policy and deferred consent approach. Study design: Prospective, single-center, feasibility study, with each starting oxygen concentration used for two months for all eligible infants. Population: Infants born at 23 + 0–28 + 6 weeks’ gestation who received delivery room resuscitation. Study interventions: Initial oxygen at 30% or 60%, increasing by 10–20% every minute for heart rate < 100 bpm, or increase to 100% for chest compressions. Primary outcome: Feasibility, defined by (i) achieving difference in cumulative supplied oxygen concentration between groups, and (ii) post-intervention rate consent >50%. Results: Thirty-four infants were born during a 4-month period; consent was obtained in 63%. Thirty (<i>n</i> = 12, 30% group; <i>n</i> = 18, 60% group) were analyzed, including limited data from eight who died or were transferred before parents could be approached. Median cumulative oxygen concentrations were significantly different between the two groups in the first 5 min. Conclusion: Randomized control trial of 30% or 60% oxygen at the initiation of resuscitation of extremely preterm neonates with deferred consent is feasible. Trial registration: Clinicaltrials.gov NCT03706586Brenda Hiu Yan LawElizabeth AsztalosNeil N. FinerMaryna YaskinaMaximo VentoWilliam Tarnow-MordiPrakesh S. ShahGeorg M. SchmölzerMDPI AGarticleinfantnewborndelivery roomneonatal resuscitationoxygen concentrationPediatricsRJ1-570ENChildren, Vol 8, Iss 942, p 942 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	infant newborn delivery room neonatal resuscitation oxygen concentration Pediatrics RJ1-570
spellingShingle	infant newborn delivery room neonatal resuscitation oxygen concentration Pediatrics RJ1-570 Brenda Hiu Yan Law Elizabeth Asztalos Neil N. Finer Maryna Yaskina Maximo Vento William Tarnow-Mordi Prakesh S. Shah Georg M. Schmölzer Higher versus Lower Oxygen Concentration during Respiratory Support in the Delivery Room in Extremely Preterm Infants: A Pilot Feasibility Study
description	Background: Optimal starting oxygen concentration for delivery room resuscitation of extremely preterm infants (<29 weeks) remains unknown, with recommendations of 21–30% based on uncertain evidence. Individual patient randomized trials designed to answer this question have been hampered by poor enrolment. Hypothesis: It is feasible to compare 30% vs. 60% starting oxygen for delivery room resuscitation of extremely preterm infants using a change in local hospital policy and deferred consent approach. Study design: Prospective, single-center, feasibility study, with each starting oxygen concentration used for two months for all eligible infants. Population: Infants born at 23 + 0–28 + 6 weeks’ gestation who received delivery room resuscitation. Study interventions: Initial oxygen at 30% or 60%, increasing by 10–20% every minute for heart rate < 100 bpm, or increase to 100% for chest compressions. Primary outcome: Feasibility, defined by (i) achieving difference in cumulative supplied oxygen concentration between groups, and (ii) post-intervention rate consent >50%. Results: Thirty-four infants were born during a 4-month period; consent was obtained in 63%. Thirty (<i>n</i> = 12, 30% group; <i>n</i> = 18, 60% group) were analyzed, including limited data from eight who died or were transferred before parents could be approached. Median cumulative oxygen concentrations were significantly different between the two groups in the first 5 min. Conclusion: Randomized control trial of 30% or 60% oxygen at the initiation of resuscitation of extremely preterm neonates with deferred consent is feasible. Trial registration: Clinicaltrials.gov NCT03706586
format	article
author	Brenda Hiu Yan Law Elizabeth Asztalos Neil N. Finer Maryna Yaskina Maximo Vento William Tarnow-Mordi Prakesh S. Shah Georg M. Schmölzer
author_facet	Brenda Hiu Yan Law Elizabeth Asztalos Neil N. Finer Maryna Yaskina Maximo Vento William Tarnow-Mordi Prakesh S. Shah Georg M. Schmölzer
author_sort	Brenda Hiu Yan Law
title	Higher versus Lower Oxygen Concentration during Respiratory Support in the Delivery Room in Extremely Preterm Infants: A Pilot Feasibility Study
title_short	Higher versus Lower Oxygen Concentration during Respiratory Support in the Delivery Room in Extremely Preterm Infants: A Pilot Feasibility Study
title_full	Higher versus Lower Oxygen Concentration during Respiratory Support in the Delivery Room in Extremely Preterm Infants: A Pilot Feasibility Study
title_fullStr	Higher versus Lower Oxygen Concentration during Respiratory Support in the Delivery Room in Extremely Preterm Infants: A Pilot Feasibility Study
title_full_unstemmed	Higher versus Lower Oxygen Concentration during Respiratory Support in the Delivery Room in Extremely Preterm Infants: A Pilot Feasibility Study
title_sort	higher versus lower oxygen concentration during respiratory support in the delivery room in extremely preterm infants: a pilot feasibility study
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/63d501caee234c86a909adea29acc323
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Higher versus Lower Oxygen Concentration during Respiratory Support in the Delivery Room in Extremely Preterm Infants: A Pilot Feasibility Study

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