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Initiation of respiratory support for extremely preterm infants at birth
  1. Madeleine C Murphy1,2,3,
  2. Lisa K McCarthy1,2,
  3. Colm P F O’Donnell1,2
  1. 1 Department of Neonatology, National Maternity Hospital, Dublin, Ireland
  2. 2 School of Medicine, University College, Dublin, Ireland
  3. 3 National Children's Research Centre, Dublin, Ireland
  1. Correspondence to Professor Colm P F O’Donnell, Neonatal Intensive Care Unit, National Maternity Hospital, Dublin D02 YH21, Ireland; codonnell{at}


Neonatal resuscitation algorithms recommend assessing breathing and heart rate (HR) of newborns and giving respiratory support when one or both are unsatisfactory. Recommendations also state that preterm infants may be supported with continuous positive airway pressure rather than routinely intubated for positive pressure ventilation (PPV). We wished to describe the prevalence and time of initiation of respiratory support of extremely preterm and extremely low birthweight (ELBW) infants at our hospital. We reviewed videos of 55 infants. Although most were breathing, practically all newly born extremely preterm ELBW infants were given respiratory support soon after arrival to the resuscitation cot. For the majority, this was done without knowing the HR. The majority received PPV; again, this was often done without knowing the HR. A quarter of infants were managed without any PPV.

  • resuscitation
  • neonatology

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  • Presented at Abstract has been accepted for poster presentation at the PAS 2020 meeting, Philadelphia, USA, 2020.

  • Contributors MCM contributed to study concept, study design, data collection and analysis, and writing of the initial draft of the manuscript. LKM and CPFO contributed to study concept, study design, supervision of the study and editing of the final submission.

  • Funding MCM is supported by a Clinical Research Fellowship from the National Children’s Research Centre, Our Lady’s Children’s Hospital, Crumlin, Dublin, Ireland (R17637).

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval Given the precipitous nature of some deliveries, our research ethics committee approved the study for deferred informed consent.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement All data relevant to the study are included in the article or uploaded as supplementary information.