Ventilation devices for neonatal resuscitation at birth: A systematic review and meta-analysis.

[en] ("[en] UNLABELLED: Initial management of inadequate adaptation to extrauterine life relies on non-invasive respiratory support. Two types of devices are available: fixed pressure devices (FPD; T-pieces or ventilators) and hand driven pressure devices (HDPD; self- or flow-inflating bags). This systematic review and meta-analysis aims to compare clinical outcomes after neonatal resuscitation according to device type. METHODS: Four databases were searched from inception to 2022, January. Search strategies included Mesh/Emtree terms as well as free language without any restriction. Randomized, quasi-randomized studies and prospective cohorts comparing the use of the two types of devices in neonatal resuscitation were included. RESULTS: Nine studies recruiting 3621 newborns were included: 5 RCTs, 2 RCTs with interventions bundles and 2 prospective cohorts. Meta-analysis of the 5 RCTs demonstrated significant reductions in bronchopulmonary dysplasia (RR0,68[0,48-0,96]-NNT 31) and other respiratory outcomes: intubation in the delivery room (RR0,72[0,58-0,88]-NNT 13,4), mechanical ventilation requirements (RR0,81[0,67-0,96]-NNT 17) and duration (MD-1,54 days[-3,03- -0,05]), need for surfactant (RR0,79[0,64-0,96]-NNT 7,3). The overall analysis found a lower mortality in the FPD group (OR0,57[0,47-0,69]-NNT 12,7) and confirmed decreases in intubation, surfactant requirement and mechanical ventilation rates (OR 0,56[0,40-0,79]- NNT7,5; OR 0,67[0,55-0,82]-NNT10,7 and OR0,58[0,42-0,80]- NNT 7,4 respectively). The risk of cystic periventricular leukomalacia (cPVL) decreased significantly with FPD (OR0.59[0.41-0.85]-NNT 27). Pneumothorax rates were similar (OR0.82[0.44-1.52]). CONCLUSION AND RELEVANCE: Resuscitation at birth with FPD improves respiratory transition and decreases BPD with a very low to moderate certainty of evidence. There is suggestion of decreases in mortality and cPVL. Further studies are still needed to confirm those results.","[en] ","")

Disciplines :

Pediatrics
Anesthesia & intensive care

Author, co-author :

Tribolet, Sophie ; Centre Hospitalier Universitaire de Liège - CHU > > Service néonatologie (CHR)

HENNUY, Nadège ; Centre Hospitalier Universitaire de Liège - CHU > > Service néonatologie (CHR)

Rigo, Vincent ; Centre Hospitalier Universitaire de Liège - CHU > > Service néonatologie (CHR) ; Université de Liège - ULiège > Département des sciences cliniques > Néonatologie

Language :

English

Title :

Ventilation devices for neonatal resuscitation at birth: A systematic review and meta-analysis.

Alternative titles :

[fr] Dispositifs de ventilation pour la réanimation à la naissance: revue systématique et méta-analyse

Publication date :

06 January 2023

Journal title :

Resuscitation

ISSN :

0300-9572

eISSN :

1873-1570

Publisher :

Elsevier BV, Ireland

Volume :

183

Pages :

109681

Peer reviewed :

Peer Reviewed verified by ORBi

Additional URL :

https://www.resuscitationjournal.com/article/S0300-9572(22)00754-7/fulltext

Commentary :

Open access sur le site de l'éditeur. https://www.resuscitationjournal.com/article/S0300-9572(22)00754-7/fulltext

Available on ORBi :

since 02 June 2023

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Bibliography

Hooper, S.B., Polglase, G.R., Roehr, C.C., Cardiopulmonary changes with aeration of the newborn lung. Paediatr Respir Rev 16 (2015), 147–150.
te Pas, A.B., Davis, P.G., Hooper, S.B., Morley, C.J., From liquid to air: breathing after birth. J Pediatr 152 (2008), 607–611.
Bjorland, P.A., Øymar, K., Ersdal, H.L., Rettedal, S.I., Incidence of newborn resuscitative interventions at birth and short-term outcomes: a regional population-based study. BMJ Paediatr Open, 3, 2019, e000592.
Niles, D.E., Cines, C., Insley, E., et al. Incidence and characteristics of positive pressure ventilation delivered to newborns in a US tertiary academic hospital. Resuscitation 115 (2017), 102–109.
Aziz, K., Lee, H.C., Escobedo, M.B., et al. Part 5: Neonatal Resuscitation 2020 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Pediatrics 1471 (2021), S160–S190.
Madar, J., Roehr, C.C., Ainsworth, S., et al. European Resuscitation Council Guidelines 2021: Newborn resuscitation and support of transition of infants at birth. Resuscitation 161 (2021), 291–326.
Wyckoff, M.H., Singletary, E.M., Soar, J., et al. 2021 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations: Summary From the Basic Life Support; Advanced Life Support; Neonatal Life Support; Education, Implementation, and Teams; First Aid Task Forces; and the COVID-19 Working Group. Resuscitation 169 (2021), 229–311.
Morley, C.J., Dawson, J.A., Stewart, M.J., Hussain, F., Davis, P.G., The effect of a PEEP valve on a Laerdal neonatal self-inflating resuscitation bag. J Paediatr Child Health 46 (2010), 51–56.
Hawkes, C.P., Ryan, C.A., Dempsey, E.M., Comparison of the T-piece resuscitator with other neonatal manual ventilation devices: a qualitative review. Resuscitation 83 (2012), 797–802.
Hinder, M., Tracy, M., Newborn resuscitation devices: The known unknowns and the unknown unknowns. Semin Fetal Neonatal Med, 26, 2021, 101233.
Trevisanuto, D., Satariano, I., Doglioni, N., et al. Changes over time in delivery room management of extremely low birth weight infants in Italy. Resuscitation 85 (2014), 1072–1076.
Jayaram, A., Sima, A., Barker, G., Thacker, L.R., T-Piece Resuscitator Versus Self-Inflating Bag for Preterm Resuscitation: An Institutional Experience. Respir Care 58 (2013), 1233–1236.
Siripattanapipong, P., Nakornchai, K., Wutthigate, P., et al. Effectiveness of T-Piece Resuscitator versus Self-inflating bag during birth resuscitation in very low birth weight infants. Southeast Asian J Trop Med Public Health 48 (2017), 249–255.
Birenbaum, H.J., Dentry, A., Cirelli, J., et al. Reduction in the incidence of chronic lung disease in very low birth weight infants: results of a quality improvement process in a tertiary level neonatal intensive care unit. Pediatrics 123 (2009), 44–50.
Hishikawa, K., Goishi, K., Fujiwara, T., Kaneshige, M., Ito, Y., Sago, H., Pulmonary air leak associated with CPAP at term birth resuscitation. Arch Dis Child - Fetal Neonatal Ed 100 (2015), F382–F387.
Smithhart, W., Wyckoff, M.H., Kapadia, V., et al. Delivery Room Continuous Positive Airway Pressure and Pneumothorax. Pediatrics, 144, 2019, e20190756.
Trevisanuto D, Roehr CC, Davis PG, et al. devices for administering ventilation at birth: A systematic review. Pediatrics. 2021;148: e2021050174.
Page, M.J., Mckenzie, J.E., Bossuyt, P.M., et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ, 372, 2021, n71.
Tufanaru, C., Munn, Z., Stephenson, M., Aromataris, E., Fixed or random effects meta-analysis? Common methodological issues in systematic reviews of effectiveness. Int J Evid Based Heal 13 (2015), 196–207.
Luo, D., Wan, X., Liu, J., Tong, T., Optimally estimating the sample mean from the sample size, median, mid-range, and/or mid-quartile range. Stat Methods Med Res 27 (2018), 1785–1805.
Wan, X., Wang, W., Liu, J., Tong, T., Estimating the sample mean and standard deviation from the sample size, median, range and/or interquartile range. BMC Med Res Methodol 14 (2014), 1–13.
Mendes, D., Alves, C., Batel-Marques, F., Number needed to treat (NNT) in clinical literature: an appraisal. BMC Med, 1(15), 2017 Jun, 112.
Schünemann, H.J., Oxman, A.D., Brozek, J., et al. Grading quality of evidence and strength of recommendations for diagnostic tests and strategies. BMJ 336 (2008), 503–508.
Strand, M.L., Simon, W.M., Wyllie, J., Wyckoff, M.H., Weiner, G., Consensus outcome rating for international neonatal resuscitation guidelines. Arch Dis Child Fetal Neonatal Ed 105 (2020), F328–F330.
Menakaya, J., Andersen, C., Chirla, D., Wolfe, R., Walkins, A., A randomised comparison of resuscitation with an anaesthetic rebreathing circuit or an infant ventilator in very preterm infants. Arch Dis Child Fetal Neonatal Ed 89 (2004), F494–F496.
Dawson JA, Schmölzer GM, Kamlin COF, et al. Oxygenation with T-piece versus self-inflating bag for ventilation of extremely preterm infants at birth: a randomized controlled trial. J Pediatr. 2011;158: 912-8.e1-2.
Kookna, S., Kumar Singh, A., Pandit, S., et al. T-Piece Resuscitator or Self Inflating Bag for Positive Pressure Ventilation during Neonatal Resuscitation: A Randomized Controlled Trial. IOSR J Dent Med Sci e-ISSN 18 (2019), 66–74.
Szyld, E., Aguilar, A., Musante, G.A., et al. Comparison of devices for newborn ventilation in the delivery room. J Pediatr 165 (2014), 234–239.
Thakur, A., Saluja, S., Modi, M., et al. T-piece or self inflating bag for positive pressure ventilation during delivery room resuscitation: An RCT. Resuscitation 90 (2015), 21–24.
El-Chimi, M.S., Awad, H.A., El-Gammasy, T.M., El-Farghali, O.G., Sallam, M.T., Shinkar, D.M., Sustained versus intermittent lung inflation for resuscitation of preterm infants: a randomized controlled trial. J Matern Fetal Neonatal Med 30 (2017), 1273–1278.
Te Pas, A.B., Walther, F.J., A randomized, controlled trial of delivery-room respiratory management in very preterm infants. Pediatrics 120 (2007), 322–329.
Ng, K.F., Choo, P., Paramasivam, U., Soelar, S.A., Reduction of intubation rate during newborn resuscitation after transition from self-inflating bag to T-piece resuscitator. Med J Malaysia 70 (2015), 228–231.
Guinsburg, R., De Almeida, M.F.B., De Castro, J.S., et al. T-piece versus self-inflating bag ventilation in preterm neonates at birth. Arch Dis Child Fetal Neonatal Ed 103 (2018), F49–F55.
Siew, M.L., Te Pas, A.B., Wallace, M.J., et al. Positive end-expiratory pressure enhances development of a functional residual capacity in preterm rabbits ventilated from birth. J Appl Physiol 106 (2009), 1487–1493.
Subramaniam, P., Ho, J.J., Davis, P.G., Prophylactic or very early initiation of continuous positive airway pressure (CPAP) for preterm infants. Cochrane Database Syst Rev, 10, 2021, CD001243.
Schmölzer, G.M., Kumar, M., Pichler, G., et al. Non-invasive versus invasive respiratory support in preterm infants at birth: systematic review and meta-analysis. BMJ, 347, 2013, f5980.
Abiramalatha, T., Bandyopadhyay, T., Ramaswamy, V.V., et al. Risk Factors for Periventricular Leukomalacia in Preterm Infants: A Systematic Review, Meta-analysis, and GRADE-Based Assessment of Certainty of Evidence. Pediatr Neurol 124 (2021), 51–71.
Björklund, L.J., Ingimarsson, J., Curstedt, T., et al. Manual ventilation with a few large breaths at birth compromises the therapeutic effect of subsequent surfactant replacement in immature lambs. Pediatr Res 42 (1997), 348–355.
Barton, S.K., Tolcos, M., Miller, S.L., et al. Unraveling the Links Between the Initiation of Ventilation and Brain Injury in Preterm Infants. Front Pediatr, 3, 2015, 97.
Polglase, G.R., Miller, S.L., Barton, S.K., et al. Initiation of Resuscitation with High Tidal Volumes Causes Cerebral Hemodynamic Disturbance, Brain Inflammation and Injury in Preterm Lambs. PLoS One, 7, 2012, e39535.
Tracy, M., Maheshwari, R., Shah, D., Hinder, M., Can Ambu self-inflating bag and Neopuff infant resuscitator provide adequate and safe manual inflations for infants up to 10 kg weight?. Arch Dis Child Fetal Neonatal Ed 102 (2017), F333–F338.
Kuypers, K., Martherus, T., Lamberska, T., Dekker, J., Hooper, S.B., Te Pas, A.B., Reflexes that impact spontaneous breathing of preterm infants at birth: A narrative review. Arch Dis Child Fetal Neonatal Ed 105 (2020), 675–679.
Van Vonderen, J.J., Kleijn, T.A., Schilleman, K., Walther, F.J., Hooper, S.B., Te Pas, A.B., Compressive force applied to a manikin's head during mask ventilation. Arch Dis Child Fetal Neonatal Ed 97 (2012), F254–F258.
Schmölzer, G.M., Dawson, J.A., Kamlin, C.O.F., O'Donnell, C.P.F., Morley, C.J., Davis, P.G., Airway obstruction and gas leak during mask ventilation of preterm infants in the delivery room. Arch Dis Child Fetal Neonatal Ed 96 (2011), F254–F257.
Foglia, E.E., Te Pas, A.B., Kirpalani, H., et al. Sustained Inflation vs Standard Resuscitation for Preterm Infants: A Systematic Review and Meta-analysis. JAMA Pediatr, 174, 2020, e195897.
Bruschettini, M., O'Donnell, C.P.F., Davis, P.G., Morley, C.J., Moja, L., Calevo, M.G., Sustained versus standard inflations during neonatal resuscitation to prevent mortality and improve respiratory outcomes. Cochrane Database Syst Rev, 2020; 2020:, CD004953.
Kapadia, V.S., Urlesberger, B., Soraisham, A., et al. Sustained lung inflations during neonatal resuscitation at birth: A meta-analysis. Pediatrics, 147, 2021, 2020021204.
Kirpalani, H., Ratcliffe, S.J., Keszler, M., et al. Effect of Sustained Inflations vs Intermittent Positive Pressure Ventilation on Bronchopulmonary Dysplasia or Death Among Extremely Preterm Infants: The SAIL Randomized Clinical Trial. JAMA 321 (2019), 1165–1175.
Kamlin, C.O.F., Schilleman, K., Dawson, J.A., et al. Mask versus nasal tube for stabilization of preterm infants at birth: a randomized controlled trial. Pediatrics 132 (2013), e381–e388.