Respiratory outcomes after delivery room stabilisation with a new respiratory support system using nasal prongs.

Abstract

To study if stabilisation using a new respiratory support system with nasal prongs compared to T-piece with a face mask is associated with less need for mechanical ventilation and bronchopulmonary dysplasia. A single-centre follow-up study of neonates born <28 weeks gestation at Karolinska University Hospital, Stockholm included in the multicentre Comparison of Respiratory Support after Delivery (CORSAD) trial and randomised to initial respiratory support with the new system versus T-piece. Data on respiratory support, neonatal morbidities and mortality were collected up to 36 weeks post-menstrual age. Ninety-four infants, 51 female, with a median (range) gestational age of 25 +2 (23 +0, 27 +6) weeks and days, were included. Significantly fewer infants in the new system group received mechanical ventilation during the first 72h, 24 (52.2%) compared with 35 (72.9%) (p= 0.034) and during the first 7 days, 29 (63.0%) compared with 39 (81.3%) (p= 0.045) in the T-piece group. At 36 weeks post-menstrual age, 13 (28.3%) in the new system and 13 (27.1%) in the T-piece group were diagnosed with bronchopulmonary dysplasia. Stabilisation with the new system was associated with less need for mechanical ventilation during the first week of life. No significant difference was seen in the outcome of bronchopulmonary dysplasia.