T-piece resuscitator versus self-inflating bag for preterm resuscitation: an institutional experience.
BACKGROUND
Manual ventilation in the delivery room is provided with devices such as self-inflating bags (SIBs), flow-inflating bags, and T-piece resuscitators.


OBJECTIVE
To compare the effect of type of manual ventilation device on overall response to resuscitation among preterm neonates born at < 35 weeks gestation.


METHODS
Retrospective data were collected in 2 time periods. Primary outcome was overall response to resuscitation, as measured by Apgar score. Secondary outcomes were incidence of air leaks, need for chest compressions/epinephrine, need for intubation, and surfactant use.


RESULTS
We identified 294 resuscitations requiring ventilation. SIB was used for 135 neonates, and T-piece was used for 159 neonates. There was no significant difference between the 1-min and 5-min Apgar scores between SIB and T-piece (P = .77 and P = .11, respectively), nor were there significant differences in secondary outcomes. The rate of rise of Apgar score was higher, by 0.47, with T-piece, compared to SIB (95% CI 0.08-0.87, P = .02).


CONCLUSIONS
Although some manikin studies favor T-piece for providing reliable and consistent pressures, our experience did not indicate significant differences in effectiveness of resuscitation between the T-piece and SIB in preterm resuscitations.
['Jayaram|Archana|A|', 'Sima|Adam|A|', 'Barker|Gail|G|', 'Thacker|Leroy R|LR|']
D001034:Apgar Score D001993:Bronchodilator Agents D057186:Comparative Effectiveness Research D004837:Epinephrine D005260:Female D005865:Gestational Age D006801:Humans D007231:Infant, Newborn D007234:Infant, Premature D007442:Intubation, Intratracheal D008297:Male D008991:Monitoring, Physiologic D063087:Noninvasive Ventilation D017063:Outcome Assessment, Health Care D012151:Resuscitation D012189:Retrospective Studies D055397:Ventilator-Induced Lung Injury D012122:Ventilators, Mechanical
T-piece resuscitation resuscitation self-inflating bag preterm manual ventilation flow-inflating bag neonate Apgar score resuscitator