Background and Aim Clinically determining appropriate respiratory support from the point of delivery to the NICU is difficult and inadvertent overventilation may be common. The aim of the study was to determine whether delivery room managements done by skilled team will produce ‘normocarbic’ blood gas values in <29 weeks’ preterm infants.
Method A prospective cohort study was designed and infants born before 29 weeks’ from January 2009 to December 2011 were enrolled. All infants received 100 mg/kg prophylactic surfactant in delivery room. During resuscitation, stabilization, surfactant administration and transport infants were ventilated with a T-piece resuscitator. If respiratory drive was present, infants were extubated to nasal CPAP through short binasal prong. FiO2 was adjusted to achive SaO2 of 88–92% which was monitored by pulse oxymeter. Carbon dioxide (CO2) levels on admission and early NICU hours (0–6 hours) were evaluated.
Results Fifty nine infants were included with a mean gestation age of 26.2±1.7 (23–28.6) weeks and a birth weight of 857±237 (400–1470). The mean pCO2 levels of the first blood gas analysis was 45.3±9.8 (range 30.4–71.2). Four (6.8%) infants had hypocarbia (pCO2 < 35 mmHg).
Conclusion To prevent both hyperoxia and hypocarbia from the point of delivery to the NICU is a challenge. More caution is required to prevent hypocarbia and hyperoxia.