RT Journal Article
SR Electronic
T1 A randomised trial of placing preterm infants on their back or left side after birth
JF Archives of Disease in Childhood - Fetal and Neonatal Edition
JO Arch Dis Child Fetal Neonatal Ed
FD BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health
SP F397
OP F400
DO 10.1136/archdischild-2015-309842
VO 101
IS 5
A1 Emily Stenke
A1 Emily A Kieran
A1 Lisa K McCarthy
A1 Jennifer A Dawson
A1 Jeroen J Van Vonderen
A1 C Omar F Kamlin
A1 Peter G Davis
A1 Arjan B Te Pas
A1 Colm P F O'Donnell
YR 2016
UL http://fn.bmj.com/content/101/5/F397.abstract
AB Background Basic life support guidelines recommend placing spontaneously breathing children and adults on their side. Though the majority of preterm newborns breathe spontaneously, they are routinely placed on their back after birth. We hypothesised that they would breathe more effectively when placed on their side.Objective To determine whether preterm newborns placed on their left side at birth, compared with those placed on their back, have higher preductal oxygen saturation (SpO2) at 5 min of life.Design/methods We randomised infants <32 weeks to be placed on their back or on their left side immediately after birth. Respiratory support was given with a T-piece and face mask with initial fraction of inspired oxygen (FiO2) of 0.3. The FiO2 was increased if SpO2 was <70% at 5 min.Results We enrolled 87 infants, 41 randomised to back and 46 to left side. The groups were well matched for demographic variables. Fourteen (6 back and 8 left side) infants did not receive respiratory support in the first 5 min. The mean (SD) SpO2 was not different between the groups (back 72 (23) % versus left side 71 (24) %, p=0.956). We observed no adverse effects of placing infants on their side and found no differences in secondary outcomes between the groups.Conclusions Preterm infants on their left side did not have higher SpO2 at 5 min of life. Placing preterm infants on their side at birth is feasible and appears to be a reasonable alternative to placing them on their back.Trial registration number ISRCTN74486341.