T-piece versus self-inflating bag ventilation in preterm neonates at birth
| Autor: | Jucile Meneses, Ruth Guinsburg, Vera Lúcia Jornada Krebs, Maria Rafaela Conde González, Juliana P. Santos, Ana Lucia Acquesta, Edna Maria de Albuquerque Diniz, Regina P. G. Vieira Cavalcanti da Silva, João Henrique de Almeida, José Maria de Andrade Lopes, Junia Sampel de Castro, Jamil Pedro de Siqueira Caldas, Renato S. Procianoy, Márcia Gomes Penido, Navantino Alves Filho, Cristina Nunes dos Santos, Ligia Maria Suppo de Souza Rugolo, Walusa Assad Gonçalves-Ferri, Patrícia Franco Marques, Maria Fernanda Branco de Almeida, José Luiz Muniz Bandeira Duarte, Francisco Eulógio Martinez, Daniela Marques de Lima Mota Ferreira, Jorge Hecker Luz |
|---|---|
| Přispěvatelé: | Universidade Federal de São Paulo (UNIFESP), Universidade de São Paulo (USP), Univ Fed Maranhao, Universidade Estadual de Campinas (UNICAMP), Universidade Estadual Paulista (Unesp), Fundacao Oswaldo Cruz, Pontificia Univ Catolica Rio Grande do Sul, Univ Fed Rio Grande do Sul, Universidade do Estado do Rio de Janeiro (UERJ), Universidade Federal de Minas Gerais (UFMG), Universidade Federal de Uberlândia (UFU), Maternidade Hilda Brandao, Hosp Estadual Sumare, Hosp Geral Pirajussara, Hosp Estadual Diadema, Universidade Estadual de Londrina (UEL), Univ Fed Parana, Inst Med Integral Prof Fernando Figueira, Inst Fernandes Figueira FIOCRUZ |
| Rok vydání: | 2018 |
| Předmět: |
Male
Resuscitator Pediatrics medicine.medical_specialty Birth weight RESSURREIÇÃO Gestational Age Infant Premature Diseases Cohort Studies Positive-Pressure Respiration 03 medical and health sciences 0302 clinical medicine Pregnancy 030225 pediatrics Humans Medicine 030212 general & internal medicine Neonatology Prospective cohort study Positive end-expiratory pressure Ventilators Mechanical business.industry Infant Newborn Pregnancy Outcome Obstetrics and Gynecology Gestational age Insufflation Equipment Design General Medicine medicine.disease Respiration Artificial Survival Analysis Patient Discharge Bronchopulmonary dysplasia Pediatrics Perinatology and Child Health Premature Birth Female business Brazil Infant Premature Neonatal resuscitation |
| Zdroj: | Repositório Institucional da USP (Biblioteca Digital da Produção Intelectual) Universidade de São Paulo (USP) instacron:USP Web of Science Repositório Institucional da UNESP Universidade Estadual Paulista (UNESP) instacron:UNESP |
| Popis: | Made available in DSpace on 2018-11-26T15:46:05Z (GMT). No. of bitstreams: 0 Previous issue date: 2018-01-01 Objective To verify whether the use of the T-piece resuscitator compared with the self-inflating bag in preterm infants ventilated at birth modifies survival to hospital discharge without major morbidities. Design Pragmatic prospective cohort study. Setting 20 Brazilian university hospitals of Brazilian Network on Neonatal Research. Patients were 1962 inborn infants in 2014-2015 ventilated at birth with 23-33' weeks gestation and birth weight 400-1499 g without malformations. Patients transferred until the 27th day after birth were excluded. Interventions Positive pressure ventilation at birth with T-piece resuscitator or self-inflating bag without positive end expiratory pressure valve. Intervention with ventilation followed the Brazilian Society of Pediatrics guidelines. The choice of the equipment was at the neonatologist's discretion in each delivery. The main outcome measures were survival to hospital discharge without bronchopulmonary dysplasia, severe peri-intraventricular haemorrhage and periventricular leucomalada. Logistic regression adjusted for confounding variables was applied for main outcome. Results 1456 (74%) were only ventilated with T-piece resuscitator and 506 (26%) with the self-inflating bag. The characteristics of those ventilated with T-Piece resuscitator versus self-inflating bag were birth weight 969 +/- 277 vs 941 +/- 279 g, gestational age 28.2 +/- 2.5 vs 27.8 +/- 2.7 weeks and survival to hospital discharge without major morbidities 47% vs 35%, Logistic regression adjusted for maternal characteristics, obstetric and neonatal morbidities showed that the T-piece resuscitator increased the chance of survival to hospital discharge without major morbidities (OR=1.38; 95% Cl 1.06 to 1.80; Hosmer-Lemeshow goodness of fit: 0.695). Conclusion This study is the first that highlights the effectiveness of T-piece resuscitator ventilation in improving relevant outcomes in preterm neonates. Univ Fed Sao Paulo, Div Neonatal Med, Sao Paulo, Brazil Univ Sao Paulo, Dept Pediat, Fac Med Ribeirao Preto, Ribeirao Preto, Brazil Univ Fed Maranhao, Dept Pediat, Sao Luis, Brazil Univ Estadual Campinas, Dept Pediat, Fac Ciencias Med, Campinas, SP, Brazil Univ Sao Paulo, Dept Pediat, Fac Med, Sao Paulo, Brazil Univ Estadual Paulista, Div Neonatol, Fac Med Botucatu, Botucatu, SP, Brazil Fundacao Oswaldo Cruz, Div Neonatol, Rio De Janeiro, Brazil Pontificia Univ Catolica Rio Grande do Sul, Dept Pediat, Hosp Sao Lucas, Fac Med, Porto Alegre, RS, Brazil Univ Fed Rio Grande do Sul, Div Neonatol, Hosp Clin Porto Alegre, Porto Alegre, RS, Brazil Univ Estado Rio de Janeiro, Dept Pediat, Hosp Univ Pedro Ernesto, Rio De Janeiro, Brazil Univ Fed Minas Gerais, Div Neonatol, Belo Horizonte, MG, Brazil Univ Fed Uberlandia, Pediat, Uberlandia, MG, Brazil Maternidade Hilda Brandao, Dept Pediat, Fac Ciencias Med Minas Gerais, Belo Horizonte, MG, Brazil Univ Sao Paulo, Sch Med, Dept Pediat, Sao Paulo, SP, Brazil Hosp Estadual Sumare, Neonatal Div, Sumare, Brazil Hosp Geral Pirajussara, Neonatal Unit, Taboao Da Serra, Brazil Hosp Estadual Diadema, Neonatal Unit, Diadema, Brazil Univ Estadual Londrina, Dept Pediat, Hosp Univ, Curitiba, Parana, Brazil Univ Fed Parana, Dept Pediat, Hosp Clin, Curitiba, Parana, Brazil Inst Med Integral Prof Fernando Figueira, Dept Pediat, Recife, PE, Brazil Inst Fernandes Figueira FIOCRUZ, Dept Pediat, Rio De Janeiro, Brazil Univ Estadual Paulista, Div Neonatol, Fac Med Botucatu, Botucatu, SP, Brazil |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|