RT Journal Article
SR Electronic
T1 Face mask versus nasal prong or nasopharyngeal tube for neonatal resuscitation in the delivery room: a systematic review and meta-analysis
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 561
OP 567
DO 10.1136/archdischild-2020-319460
VO 106
IS 5
A1 Avneet Mangat
A1 Marlies Bruckner
A1 Georg M Schmölzer
YR 2021
UL http://fn.bmj.com/content/106/5/561.abstract
AB Importance The current neonatal resuscitation guidelines recommend positive pressure ventilation via face mask or nasal prongs at birth. Using a nasal interface may have the potential to improve outcomes for newborn infants.Objective To determine whether nasal prong/nasopharyngeal tube versus face mask during positive pressure ventilation of infants born <37 weeks’ gestation in the delivery room reduces in-hospital mortality and morbidity.Data sources MEDLINE (through PubMed), Google Scholar and EMBASE, Clinical Trials.gov and the Cochrane Central Register of Controlled Trials through August 2019.Study selection Randomised controlled trials comparing nasal prong/nasopharyngeal tube versus face mask during positive pressure ventilation of infants born <37 weeks’ gestation in the delivery room.Data analysis Risk of bias was assessed using the Covidence Collaboration Tool, results were pooled into a meta-analysis using a random effects model.Main outcome In-hospital mortality.Results Five RCTs enrolling 873 infants were combined into a meta-analysis. There was no statistical difference in in-hospital mortality (risk ratio (RR 0.98, 95% CI 0.63 to 1.52, p=0.92, I2=11%), rate of chest compressions in the delivery room (RR 0.37, 95% CI 0.10 to 1.33, p=0.13, I2=28%), rate of intraventricular haemorrhage (RR 1.54, 95% CI 0.88 to 2.70, p=0.13, I2=0%) or delivery room intubations in infants ventilated with a nasal prong/tube (RR 0.63, 95% CI 0.39,1.02, p=0.06, I2=52%).Conclusion In infants born <37 weeks’ gestation, in-hospital mortality and morbidity were similar following positive pressure ventilation during initial stabilisation with a nasal prong/tube or a face mask.All data relevant to the study are included in the article or uploaded as supplementary information.