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Corrective ventilation strategies in delivery room resuscitation of preterm infants
Author(s) -
Kilmartin Keira C.,
Finn Darragh,
Hawkes Gavin A.,
Kenosi Mmoloki,
Dempsey Eugene M.,
Livingstone Vicki,
Ryan Anthony C.
Publication year - 2018
Publication title -
acta paediatrica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.772
H-Index - 115
eISSN - 1651-2227
pISSN - 0803-5253
DOI - 10.1111/apa.14570
Subject(s) - medicine , intubation , resuscitation , neonatal resuscitation , anesthesia , endotracheal intubation , airway , gestation , positive pressure ventilation , ventilation (architecture) , pregnancy , respiratory failure , mechanical engineering , biology , engineering , genetics
Aim Corrective ventilation strategies ( CVS ) during neonatal resuscitation and stabilisation (R&S) are taught through the MRSOPA mnemonic: Mask adjustment, Repositioning airway, Suctioning, Opening the mouth, Increasing inspiratory Pressure, and Alternative airway. The aim was to examine the use of CVS and to investigate the relationship between MRSOPA strategies and intubation of very preterm infants <32 weeks’ gestation in the delivery room. Methods Retrospective review of video recordings of R&S of preterm infants born in Cork University Maternity Hospital, Ireland. Results In 46 resuscitation recordings, mask adjustment was observed in almost all (95.6%), followed by suctioning, (23.9%), opening the mouth (100%), increasing inspiratory pressure (81.0%) and intubation (32.6%). The most frequently used mask holds were: one‐handed (95.6%), two‐handed (63.0%), stem hold (23.8%), and modified spider hold (6.5%). There were no significant associations between individual mask holds and intubation. The more CVS employed the greater the need for intubation. Conclusion The greater the number of MRSOPA strategies used in the delivery room, the more likely intubation occurred. Further studies may identify the effect of these CVS on short‐ and long‐term outcomes, in order to enhance R&S training and clinical practice.