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Am J Perinatol 2024; 41(10): 1424-1431
DOI: 10.1055/s-0043-1769469
Original Article

Comparing Intubation Rates in the Delivery Room by Interface

Naa-Lamle Lamptey 
1   Department of Pediatrics, OSF Saint Francis Medical Center, University of Illinois College of Medicine at Peoria, Children's Hospital of Illinois, Peoria, Illinois
,
Gretchen L. Kopec
2   Division of Neonatology, OSF Saint Francis Medical Center, University of Illinois College of Medicine at Peoria, Children's Hospital of Illinois, Peoria, Illinois
,
Harveen Kaur
3   University of Illinois College of Medicine at Peoria, Peoria, Illinois
,
Ashley M. Fischer
2   Division of Neonatology, OSF Saint Francis Medical Center, University of Illinois College of Medicine at Peoria, Children's Hospital of Illinois, Peoria, Illinois
› Author Affiliations Funding None.
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Abstract

Objective Positive pressure ventilation (PPV) is crucial to the resuscitation of newborns. Although neonates often require PPV at birth, the optimal interface has not been determined. Both binasal prongs and face masks were deemed acceptable by the International Liaison Committee on Resuscitation in 2010 and have been utilized at our center since 2016; however, the choice is by provider preference. Previous studies have suggested that binasal prongs may be more effective than face masks at avoiding intubation in the delivery room. The objective of this study is to compare intubation rates of binasal prongs versus face masks for delivery room resuscitation of neonates born < 30 weeks' gestation.

Study Design This retrospective study compares delivery room intubation rates by interface for neonates < 30 weeks' gestation born between August 2016 and April 2021 at our level IV neonatal intensive care unit. Exclusion criteria included diagnosis of congenital diaphragmatic hernia, no PPV required, or no resuscitation attempted. Data collected included interface device, demographics, maternal data, delivery room data, admission data, and discharge outcomes. The three interface groups (binasal prongs, face mask, face mask, and binasal prongs) were compared utilizing chi-square, analysis of variance with post hoc analysis, and logistic regression.

Results Mean gestational ages and birth weights for the groups were 27.6 weeks and 1,126 g, 25.7 weeks and 839 g, and 27.1 weeks and 1,028 g, respectively. Neonates resuscitated with face masks were 9.9 times more likely to be intubated in the delivery room and 10.8 times more likely to be intubated at 6 hours of life compared with those resuscitated with binasal prongs after logistic regression analysis.

Conclusion The findings in our study support delivery room resuscitation with binasal prongs as a useful method in reducing the need for intubation both in the delivery room and at 6 hours of life. Further prospective studies are warranted.

Key Points

  • The International Liaison Committee on Resuscitation recommends multiple interface options for neonatal resuscitation.

  • Vermont Oxford Network endorses nasal interface for premature infants.

  • Binasal prongs are associated with lower intubation rates.

Keywords

resuscitation - PPV - binasal prongs - face mask - NRP


Publication History

Received: 20 December 2022

Accepted: 25 April 2023

Article published online:
31 May 2023

© 2023. Thieme. All rights reserved.

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