A Randomized Trial of Conditioned or Unconditioned Gases for Stabilizing Preterm Infants at Birth

Lorraine McGrory; Louise S. Owen; Marta Thio; Jennifer A. Dawson; Anthony R. Rafferty; Atul Malhotra; Peter G. Davis; C. Omar F. Kamlin

doi:10.1016/j.jpeds.2017.09.006

A Randomized Trial of Conditioned or Unconditioned Gases for Stabilizing Preterm Infants at Birth

Lorraine McGrory (Lead / Corresponding author), Louise S. Owen, Marta Thio, Jennifer A. Dawson, Anthony R. Rafferty, Atul Malhotra, Peter G. Davis, C. Omar F. Kamlin

Research output: Contribution to journal › Article › peer-review

29 Citations (Scopus)

Abstract

Objective: To determine whether the use of heated-humidified gases for respiratory support during the stabilization of infants <30 weeks of gestational age (GA) in the delivery room reduces rates of hypothermia on admission to the neonatal intensive care unit (NICU).

Study Design: A multicenter, unblinded, randomized trial was conducted in Melbourne, Australia, between February 2013 and June 2015. Infants <30 weeks of GA were randomly assigned to receive either heated-humidified gases or unconditioned gases during stabilization in the delivery room and during transport to NICU. Infants born to mothers with pyrexia >38°C were excluded. Primary outcome was rate of hypothermia on NICU admission (rectal temperature <36.5°C).

Results: A total of 273 infants were enrolled. Fewer infants in the heated-humidified group were hypothermic on admission to NICU (36/132 [27%]) compared with controls (61/141 [43%], P < .01). There was no difference in rates of hyperthermia (>37.5°C); 20% (27/132) in the heated-humidified group compared with 16% (22/141) in the controls (P = .30). There were no differences in mortality or respiratory outcomes.

Conclusions: The use of heated-humidified gases in the delivery room significantly reduces hypothermia on admission to NICU in preterm infants, without increased risk of hyperthermia.

Clinical Trial Registration: Australian and New Zealand Clinical Trials Register (www.anzctr.org.au) ACTRN12613000093785.

Original language	English
Pages (from-to)	47-53
Number of pages	7
Journal	Journal of Pediatrics
Volume	193
Early online date	26 Oct 2017
DOIs	https://doi.org/10.1016/j.jpeds.2017.09.006
Publication status	Published - Feb 2018

Keywords

delivery room
gas conditioning
humidification
hypothermia
newborn resuscitation
newborn stabilization
respiratory support

ASJC Scopus subject areas

Pediatrics, Perinatology, and Child Health

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@article{80b7bf423b6c43808dfdf6cd736dfc44,

title = "A Randomized Trial of Conditioned or Unconditioned Gases for Stabilizing Preterm Infants at Birth",

abstract = "Objective: To determine whether the use of heated-humidified gases for respiratory support during the stabilization of infants <30 weeks of gestational age (GA) in the delivery room reduces rates of hypothermia on admission to the neonatal intensive care unit (NICU).Study Design: A multicenter, unblinded, randomized trial was conducted in Melbourne, Australia, between February 2013 and June 2015. Infants <30 weeks of GA were randomly assigned to receive either heated-humidified gases or unconditioned gases during stabilization in the delivery room and during transport to NICU. Infants born to mothers with pyrexia >38°C were excluded. Primary outcome was rate of hypothermia on NICU admission (rectal temperature <36.5°C).Results: A total of 273 infants were enrolled. Fewer infants in the heated-humidified group were hypothermic on admission to NICU (36/132 [27%]) compared with controls (61/141 [43%], P < .01). There was no difference in rates of hyperthermia (>37.5°C); 20% (27/132) in the heated-humidified group compared with 16% (22/141) in the controls (P = .30). There were no differences in mortality or respiratory outcomes.Conclusions: The use of heated-humidified gases in the delivery room significantly reduces hypothermia on admission to NICU in preterm infants, without increased risk of hyperthermia.Clinical Trial Registration: Australian and New Zealand Clinical Trials Register (www.anzctr.org.au) ACTRN12613000093785.",

keywords = "delivery room, gas conditioning, humidification, hypothermia, newborn resuscitation, newborn stabilization, respiratory support",

author = "Lorraine McGrory and Owen, {Louise S.} and Marta Thio and Dawson, {Jennifer A.} and Rafferty, {Anthony R.} and Atul Malhotra and Davis, {Peter G.} and Kamlin, {C. Omar F.}",

note = "Supported by the Australian National Health and Medical Research Council Program (606789). J.A.D., L.S.O., M.T., and C.O.F.K. are recipients of a National Health and Medical Research Council (NHMRC) Early Career Fellowship and are supported by the Victorian Government's Operational Infrastructure Support Program. P.G.D. is the recipient of an NHMRC Practitioner Fellowship",

year = "2018",

month = feb,

doi = "10.1016/j.jpeds.2017.09.006",

language = "English",

volume = "193",

pages = "47--53",

journal = "Journal of Pediatrics",

issn = "0022-3476",

publisher = "Elsevier",

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TY - JOUR

T1 - A Randomized Trial of Conditioned or Unconditioned Gases for Stabilizing Preterm Infants at Birth

AU - McGrory, Lorraine

AU - Owen, Louise S.

AU - Thio, Marta

AU - Dawson, Jennifer A.

AU - Rafferty, Anthony R.

AU - Malhotra, Atul

AU - Davis, Peter G.

AU - Kamlin, C. Omar F.

N1 - Supported by the Australian National Health and Medical Research Council Program (606789). J.A.D., L.S.O., M.T., and C.O.F.K. are recipients of a National Health and Medical Research Council (NHMRC) Early Career Fellowship and are supported by the Victorian Government's Operational Infrastructure Support Program. P.G.D. is the recipient of an NHMRC Practitioner Fellowship

PY - 2018/2

Y1 - 2018/2

N2 - Objective: To determine whether the use of heated-humidified gases for respiratory support during the stabilization of infants <30 weeks of gestational age (GA) in the delivery room reduces rates of hypothermia on admission to the neonatal intensive care unit (NICU).Study Design: A multicenter, unblinded, randomized trial was conducted in Melbourne, Australia, between February 2013 and June 2015. Infants <30 weeks of GA were randomly assigned to receive either heated-humidified gases or unconditioned gases during stabilization in the delivery room and during transport to NICU. Infants born to mothers with pyrexia >38°C were excluded. Primary outcome was rate of hypothermia on NICU admission (rectal temperature <36.5°C).Results: A total of 273 infants were enrolled. Fewer infants in the heated-humidified group were hypothermic on admission to NICU (36/132 [27%]) compared with controls (61/141 [43%], P < .01). There was no difference in rates of hyperthermia (>37.5°C); 20% (27/132) in the heated-humidified group compared with 16% (22/141) in the controls (P = .30). There were no differences in mortality or respiratory outcomes.Conclusions: The use of heated-humidified gases in the delivery room significantly reduces hypothermia on admission to NICU in preterm infants, without increased risk of hyperthermia.Clinical Trial Registration: Australian and New Zealand Clinical Trials Register (www.anzctr.org.au) ACTRN12613000093785.

AB - Objective: To determine whether the use of heated-humidified gases for respiratory support during the stabilization of infants <30 weeks of gestational age (GA) in the delivery room reduces rates of hypothermia on admission to the neonatal intensive care unit (NICU).Study Design: A multicenter, unblinded, randomized trial was conducted in Melbourne, Australia, between February 2013 and June 2015. Infants <30 weeks of GA were randomly assigned to receive either heated-humidified gases or unconditioned gases during stabilization in the delivery room and during transport to NICU. Infants born to mothers with pyrexia >38°C were excluded. Primary outcome was rate of hypothermia on NICU admission (rectal temperature <36.5°C).Results: A total of 273 infants were enrolled. Fewer infants in the heated-humidified group were hypothermic on admission to NICU (36/132 [27%]) compared with controls (61/141 [43%], P < .01). There was no difference in rates of hyperthermia (>37.5°C); 20% (27/132) in the heated-humidified group compared with 16% (22/141) in the controls (P = .30). There were no differences in mortality or respiratory outcomes.Conclusions: The use of heated-humidified gases in the delivery room significantly reduces hypothermia on admission to NICU in preterm infants, without increased risk of hyperthermia.Clinical Trial Registration: Australian and New Zealand Clinical Trials Register (www.anzctr.org.au) ACTRN12613000093785.

KW - delivery room

KW - gas conditioning

KW - humidification

KW - hypothermia

KW - newborn resuscitation

KW - newborn stabilization

KW - respiratory support

U2 - 10.1016/j.jpeds.2017.09.006

DO - 10.1016/j.jpeds.2017.09.006

M3 - Article

C2 - 29106924

SN - 0022-3476

VL - 193

SP - 47

EP - 53

JO - Journal of Pediatrics

JF - Journal of Pediatrics

ER -

A Randomized Trial of Conditioned or Unconditioned Gases for Stabilizing Preterm Infants at Birth

Abstract

Keywords

ASJC Scopus subject areas

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