Outcomes of preterm infants following the introduction of room air resuscitation

Yacov Rabi; Abhay Lodha; Amuchou Soraisham; Nalini Singhal; Keith Barrington; Prakesh S Shah

doi:10.1016/j.resuscitation.2015.08.012

Outcomes of preterm infants following the introduction of room air resuscitation

Resuscitation. 2015 Nov:96:252-9. doi: 10.1016/j.resuscitation.2015.08.012. Epub 2015 Sep 7.

Authors

Yacov Rabi¹, Abhay Lodha², Amuchou Soraisham³, Nalini Singhal⁴, Keith Barrington⁵, Prakesh S Shah⁶

Affiliations

¹ Department of Paediatrics, University of Calgary, Calgary, Alberta, Canada; Alberta Children's Hospital Research Institute, Calgary, Alberta, Canada. Electronic address: jack.rabi@albertahealthservices.ca.
² Department of Paediatrics, University of Calgary, Calgary, Alberta, Canada; Alberta Children's Hospital Research Institute, Calgary, Alberta, Canada; Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada. Electronic address: abhay.lodha@albertahealthservices.ca.
³ Department of Paediatrics, University of Calgary, Calgary, Alberta, Canada; Alberta Children's Hospital Research Institute, Calgary, Alberta, Canada. Electronic address: amuchou.soraisham@albertahealthservices.ca.
⁴ Department of Paediatrics, University of Calgary, Calgary, Alberta, Canada; Alberta Children's Hospital Research Institute, Calgary, Alberta, Canada. Electronic address: nalini.singhal@albertahealthservices.ca.
⁵ Sainte Justine University Health Centre, Montréal, Quebec, Canada. Electronic address: keith.barrington@mcgill.ca.
⁶ Department of Paediatrics, University of Toronto, Toronto, Ontario, Canada; Maternal-Infant Care Research Centre, Mount Sinai Hospital, Toronto, Ontario, Canada. Electronic address: PShah@mtsinai.on.ca.

PMID: 26359156
DOI: 10.1016/j.resuscitation.2015.08.012

Abstract

Background: After 2006 most neonatal intensive care units (NICUs) in Canada stopped initiating newborn resuscitation with 100% oxygen.

Methods: In this retrospective cohort study, we compared neonatal outcomes in infants born at ≤ 27 weeks gestation that received <100% oxygen (OXtitrate group, typically 21-40% oxygen) during delivery room resuscitation to infants that received 100% oxygen (OX100 group).

Results: Data from 17 NICUs included 2326 infants, 1244 in the OXtitrate group and 1082 in the OX100 group. The adjusted odds ratio (AOR) for the primary outcome of severe neurologic injury or death was higher in the OXtitrate group compared with the OX100 group (AOR 1.36; 95% CI 1.11, 1.66). A similar increase was also noted when comparing infants initially resuscitated with room air to the OX100 group (AOR 1.33; 95% CI 1.04, 1.69). Infants in the OXtitrate group were less likely to have received either medical or surgical treatment for a patent ductus arteriosus (AOR 0.53; 95% CI 0.37, 0.74).

Conclusions: In Canadian NICUs, we observed a higher risk of severe neurologic injury or death among preterm infants of ≤ 27 weeks gestation following a change in practice to initiating resuscitation with either room air or an intermediate oxygen concentration.

Keywords: Infant; Neonatal intensive care; Oxygen; Premature; Resuscitation.

Publication types

Multicenter Study
Research Support, Non-U.S. Gov't

MeSH terms

Adult
Air
Canada / epidemiology
Delivery Rooms
Female
Follow-Up Studies
Gestational Age
Heart Arrest / mortality
Heart Arrest / therapy*
Humans
Infant
Infant Mortality / trends
Infant, Newborn
Infant, Premature*
Infant, Premature, Diseases / mortality
Infant, Premature, Diseases / therapy*
Intensive Care Units, Neonatal*
Male
Odds Ratio
Resuscitation / methods*
Retrospective Studies

Grants and funding

Canadian Institutes of Health Research/Canada