T-piece resuscitator or self-inflating bag during neonatal resuscitation: a scoping review.

Autor: Roehr CC; Newborn Services, John Radcliffe Hospital, Oxford University Hospitals, NHS Foundation Trust, Oxford, UK. charles.roehr@ouh.nhs.uk.; National Perinatal Epidemiology Unit, Nuffield Department of Population Health, Medical Sciences Division, University of Oxford, Oxford, UK. charles.roehr@ouh.nhs.uk., Davis PG; Department of Newborn Research, The Royal Women's Hospital, Melbourne, VIC, Australia.; Department of Obstetrics and Gynaecology, The University of Melbourne, Melbourne, VIC, Australia., Weiner GM; Division of Neonatal-Perinatal Medicine, C.S. Mott Children's Hospital, University of Michigan, Ann Arbor, MI, USA., Jonathan Wyllie J; Department of Neonatology, The James Cook University Hospital, Middlesbrough, UK., Wyckoff MH; Division of Neonatal-Perinatal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA., Trevisanuto D; Department of Women's and Children's Health, University of Padova, Padova, Italy.
Jazyk: angličtina
Zdroj: Pediatric research [Pediatr Res] 2021 Mar; Vol. 89 (4), pp. 760-766. Date of Electronic Publication: 2020 Jun 11.
DOI: 10.1038/s41390-020-1005-4
Abstrakt: Background: To identify the evidence for administering positive pressure ventilation (PPV) to infants at birth by either T-piece resuscitator (TPR) or self-inflating bag (SIB), and to determine whether a full systematic review (SR) is warranted.
Methods: Guided by the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for scoping reviews, eligible studies included peer-reviewed human studies, prospectively or retrospectively comparing a TPR vs. SIB for administering PPV at birth. Databases searched were OVID Medline, PubMed, Embase and the Cochrane Central Register of Controlled Trials. Review Manager software was used for the data analysis.
Results: Following electronic literature search and review, data from four eligible studies (3 RCT and 1 observational study), enrolling a total of 2889 patients, were included. Studies differed regarding the investigated populations, reported outcomes and came from different geographical areas. In particular for preterm infants, use of TPR for providing PPV may improve survival, result in fewer intubations at birth and decrease the incidence of bronchopulmonary dysplasia.
Conclusions: This scoping review identified two new studies with substantive new evidence, pointing towards improved survival, decreased bronchopulmonary dysplasia and fewer intubations at birth, in particular among preterm infants treated with TPR. Full SR of the literature is advised.
Impact: This scoping review identified studies comparing TPR vs. SIB for respiratory support of newborn infants previously not included in the International Liaison Committee on Resuscitation (ILCOR) recommendations. Our review found substantive new evidence highlighting that device choice may impact the outcomes of compromised newborn infants'. This scoping review stipulates the need for full SR and updated meta-analysis of studies investigating supportive equipment for stabilizing infants at birth in order to inform ILCOR treatment recommendations.
Databáze: MEDLINE
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