Background Transitional delay in postnatal respiratory adaptation including transient tachypnea of the neonate (TTN) as a result of failure to clear fetal lung fluid is not uncommon and can be problematic in some infants delivered by elective ceserean delivery. (ECD)
Objective We hypothesise that application of CPAP at birth via T-piece based neopuff to infants delivered at 34–39th gestational week by ECD delivery may enhance airway liquid clearance and decrease the rate of failure in respiratory adaptation and related NICU hospitalisation.
Methods Spontenously breathing infants who were delivered by ECS were randomised either to receieve CPAP, 5 cmH20 administered via face mask for 20 min with 25–30% O2(intervention group) or to be managed with standard care in DR. Respiratory outcomes were assessed and modified Silvermann score, respiratory rate, heart rate, oxygen saturations were serially recorded for the first six hours.
Results 16 (% 5.8)infants out of 273 infants, 137 intervention and 136 control were hospitalised in the NICU because of respiratory distress. 7 of 16 patients were TTN where as the others transitional delay. Respiratory hospitalisation rate was significantly lower for the intervention group (4/137%8.8 vs12/136 2.2 p = 0.035). The preventive effect of CPAP on TTN could not reach to statistical significance (% 4.4 vs 0.72 p = 0.06). No adverse complication including pneumothorax was noted.
Conclusions Delivery room early CPAP intervention decreased the rate of failure in respiratory adaptation without causing pneumothorax in infants delivered by ECD.
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