Am J Perinatol 2014; 31(12): 1031-1036
DOI: 10.1055/s-0034-1370350
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Neonatal Resuscitation Using a Nasal Cannula: A Single-Center Experience

Pedro Paz
1   Division of Neonatal Medicine, LAC + USC Medical Center, Children's Hospital Los Angeles, Keck School of Medicine of the University of Southern California, Los Angeles, California
,
Rangasamy Ramanathan
1   Division of Neonatal Medicine, LAC + USC Medical Center, Children's Hospital Los Angeles, Keck School of Medicine of the University of Southern California, Los Angeles, California
2   Neonatal Respiratory Therapy Department, LAC + USC Medical Center, Los Angeles, California
,
Richard Hernandez
2   Neonatal Respiratory Therapy Department, LAC + USC Medical Center, Los Angeles, California
,
Manoj Biniwale
1   Division of Neonatal Medicine, LAC + USC Medical Center, Children's Hospital Los Angeles, Keck School of Medicine of the University of Southern California, Los Angeles, California
› Author Affiliations
Further Information

Publication History

10 December 2013

06 January 2014

Publication Date:
28 February 2014 (online)

Abstract

Objective The aim of the study was to describe our experience using a modified nasal cannula to deliver nasal continuous positive airway pressure and/or nasal intermittent positive pressure ventilation during primary neonatal resuscitation of preterm and term newborns.

Study Design Data were collected retrospectively for all neonates resuscitated with nasal cannula in the delivery room. The primary outcome was the number of newborns intubated in the delivery room. Secondary outcomes included need for chest compressions, intubations in the first 24 hours, air-leaks, and surfactant administration.

Results A total of 102 infants were resuscitated using nasal cannula. Eight (7.8%) were intubated in the delivery room, five (4.9%) required chest compressions, and five (4.9%) had pneumothorax noted on chest X-ray. No deaths occurred in the delivery room. Twenty-eight patients (27.5%) received early rescue surfactant after admission to the neonatal intensive care unit.

Conclusion Neonatal resuscitation can be effectively performed in preterm and term newborns using a modified nasal cannula in the delivery room.

 
  • References

  • 1 De Paoli AG, Morley C, Davis PG. Nasal CPAP for neonates: what do we know in 2003?. Arch Dis Child Fetal Neonatal Ed 2003; 88 (3) F168-F172
  • 2 Ramanathan R. Optimal ventilatory strategies and surfactant to protect the preterm lungs. Neonatology 2008; 93 (4) 302-308
  • 3 Finer NN, Rich W, Wang C, Leone T. Airway obstruction during mask ventilation of very low birth weight infants during neonatal resuscitation. Pediatrics 2009; 123 (3) 865-869
  • 4 Schmölzer GM, Dawson JA, Kamlin CO, O'Donnell CP, Morley CJ, Davis PG. Airway obstruction and gas leak during mask ventilation of preterm infants in the delivery room. Arch Dis Child Fetal Neonatal Ed 2011; 96 (4) F254-F257
  • 5 Gittermann MK, Fusch C, Gittermann AR, Regazzoni BM, Moessinger AC. Early nasal continuous positive airway pressure treatment reduces the need for intubation in very low birth weight infants. Eur J Pediatr 1997; 156 (5) 384-388
  • 6 Finer NN, Carlo WA, Walsh MC , et al; SUPPORT Study Group of the Eunice Kennedy Shriver NICHD Neonatal Research Network. Early CPAP versus surfactant in extremely preterm infants. N Engl J Med 2010; 362 (21) 1970-1979
  • 7 Aghai ZH, Saslow JG, Nakhla T , et al. Synchronized nasal intermittent positive pressure ventilation (SNIPPV) decreases work of breathing (WOB) in premature infants with respiratory distress syndrome (RDS) compared to nasal continuous positive airway pressure (NCPAP). Pediatr Pulmonol 2006; 41 (9) 875-881
  • 8 Ali N, Claure N, Alegria X, D'Ugard C, Organero R, Bancalari E. Effects of non-invasive pressure support ventilation (NI-PSV) on ventilation and respiratory effort in very low birth weight infants. Pediatr Pulmonol 2007; 42 (8) 704-710
  • 9 Kamlin CO, Schilleman K, Dawson JA , et al. Mask versus nasal tube for stabilization of preterm infants at birth: a randomized controlled trial. Pediatrics 2013; 132 (2) e381-e388
  • 10 McCarthy LK, Twomey AR, Molloy EJ, Murphy JFA, O'Donnell CPF. A randomized trial of nasal prong or face mask for respiratory support for preterm newborns. Pediatrics 2013; 132 (2) e389-e395
  • 11 Capasso L, Capasso A, Raimondi F, Vendemmia M, Araimo G, Paludetto R. A randomized trial comparing oxygen delivery on intermittent positive pressure with nasal cannulae versus facial mask in neonatal primary resuscitation. Acta Paediatr 2005; 94 (2) 197-200
  • 12 Sweet DG, Carnielli V, Greisen G , et al; European Association of Perinatal Medicine. European consensus guidelines on the management of neonatal respiratory distress syndrome in preterm infants—2010 update. Neonatology 2010; 97 (4) 402-417
  • 13 Andaya S, Ramanathan R, Sardesai S , et al. Nasal respiratory support in preterm infants: a novel means of delivering time cycled, pressure and flow limited intermittent mandatory ventilation via nasal cannula. J Investig Med 2010; 58: A429
  • 14 Friedlich P, Lecart C, Posen R, Ramicone E, Chan L, Ramanathan R. A randomized trial of nasopharyngeal-synchronized intermittent mandatory ventilation versus nasopharyngeal continuous positive airway pressure in very low birth weight infants after extubation. J Perinatol 1999; 19 (6, Pt 1) 413-418
  • 15 Kattwinkel J, Bloom RS , American Academy of Pediatrics, American Heart Association. Textbook of Neonatal Resuscitation. Elk Grove Village, IL: American Academy of Pediatrics; 2011
  • 16 Verder H, Robertson B, Greisen G , et al; Danish-Swedish Multicenter Study Group. Surfactant therapy and nasal continuous positive airway pressure for newborns with respiratory distress syndrome. N Engl J Med 1994; 331 (16) 1051-1055
  • 17 Bohlin K, Gudmundsdottir T, Katz-Salamon M, Jonsson B, Blennow M. Implementation of surfactant treatment during continuous positive airway pressure. J Perinatol 2007; 27 (7) 422-427
  • 18 Morley CJ, Davis PG, Doyle LW, Brion LP, Hascoet JM, Carlin JB ; COIN Trial Investigators. Nasal CPAP or intubation at birth for very preterm infants. N Engl J Med 2008; 358 (7) 700-708
  • 19 Kirpalani H, Millar D, Lemyre B, Yoder BA, Chiu A, Roberts RS ; NIPPV Study Group. A trial comparing noninvasive ventilation strategies in preterm infants. N Engl J Med 2013; 369 (7) 611-620
  • 20 Ramanathan R, Sekar KC, Rasmussen M, Bhatia J, Soll RF. Nasal intermittent positive pressure ventilation after surfactant treatment for respiratory distress syndrome in preterm infants <30 weeks' gestation: a randomized, controlled trial. J Perinatol 2012; 32 (5) 336-343