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Immediate Intubation at Birth of the Very-Low-Birth-Weight Infant: Effect on Survival

Immediate Intubation at Birth of the Very-Low-Birth-Weight Infant: Effect on Survival Abstract • Two policies of resuscitation at birth were compared: mandatory intubation and stabilization of the airway with continuous positive airway pressure (the electively intubated group), and intubation used according to clinical judgment (selectively intubated group), in infants with a birth weight of 501 to 1,500 g. Of 69 infants electively intubated, 53 (77%) survived; of 96 infants selectively intubated, 49 (51%) survived. Benefits from elective intubation were a higher five-minute Apgar score, less metabolic acidosis within four hours of birth, and fewer ventilatory requirements. Pneumothorax occurred in 33% of the selectively intubated infants and 20% of those electively intubated. Bronchopulmonary dysplasia occurred in 14% of infants electively intubated and 8% of those in the selectively intubated group; retrolental fibroplasia occurred in 16% and 12.2%, respectively. Long-term study showed that laryngeal problems were minimal, occurring in only one of the electively intubated infants. (Am J Dis Child 1982;136:207-210) References 1. The Consultative Council on Maternal and Perinatal Mortality: Survey of Perinatal Deaths and Report on Maternal Deaths in Victoria: Sixteenth Annual Report for the Year 1977 . Department of Health, Victoria, 1978, p 18. 2. Care of the newborn in the delivery room, Committee on Fetus and Newborn of the American Academy of Pediatrics . Pediatrics 1979; 64:970. 3. Klaus MH, Fanaroff AA: Care of the High-risk Neonate , ed 2. Philadelphia, WB Saunders Co, 1979, p 207. 4. Siegel S: Nonparametric Statistics for the Behavioral Sciences . Tokyo, McGraw-Hill Kogakusha Ltd, 1956, p 127. 5. Bowes WA Jr, Taylor ES, O'Brien M, et al: Breech delivery: Evaluation of the method of delivery on perinatal results and maternal morbidity . Am J Obstet Gynecol 1979;135:965-973. 6. Tanswell AK, Clubb RA, Smith BT, et al: Individualised continuous distending pressure applied within six hours of delivery in infants with respiratory distress syndrome . Arch Dis Ch ildh 1980;55:33-39.Crossref 7. Lubchenco LO, Hansman C, Dressler M, et al: Intrauterine growth as estimated from live-born birth-weight data at 24 to 42 weeks of gestation . Pediatrics 1963;32:793-800. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png American Journal of Diseases of Children American Medical Association

Immediate Intubation at Birth of the Very-Low-Birth-Weight Infant: Effect on Survival

Drew, John H.
American Journal of Diseases of Children , Volume 136 (3) – Mar 1, 1982
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References (9)

Publisher
American Medical Association
Copyright
Copyright © 1982 American Medical Association. All Rights Reserved.
ISSN
0002-922X
DOI
10.1001/archpedi.1982.03970390021006
Publisher site
See Article on Publisher Site

Abstract

Abstract • Two policies of resuscitation at birth were compared: mandatory intubation and stabilization of the airway with continuous positive airway pressure (the electively intubated group), and intubation used according to clinical judgment (selectively intubated group), in infants with a birth weight of 501 to 1,500 g. Of 69 infants electively intubated, 53 (77%) survived; of 96 infants selectively intubated, 49 (51%) survived. Benefits from elective intubation were a higher five-minute Apgar score, less metabolic acidosis within four hours of birth, and fewer ventilatory requirements. Pneumothorax occurred in 33% of the selectively intubated infants and 20% of those electively intubated. Bronchopulmonary dysplasia occurred in 14% of infants electively intubated and 8% of those in the selectively intubated group; retrolental fibroplasia occurred in 16% and 12.2%, respectively. Long-term study showed that laryngeal problems were minimal, occurring in only one of the electively intubated infants. (Am J Dis Child 1982;136:207-210) References 1. The Consultative Council on Maternal and Perinatal Mortality: Survey of Perinatal Deaths and Report on Maternal Deaths in Victoria: Sixteenth Annual Report for the Year 1977 . Department of Health, Victoria, 1978, p 18. 2. Care of the newborn in the delivery room, Committee on Fetus and Newborn of the American Academy of Pediatrics . Pediatrics 1979; 64:970. 3. Klaus MH, Fanaroff AA: Care of the High-risk Neonate , ed 2. Philadelphia, WB Saunders Co, 1979, p 207. 4. Siegel S: Nonparametric Statistics for the Behavioral Sciences . Tokyo, McGraw-Hill Kogakusha Ltd, 1956, p 127. 5. Bowes WA Jr, Taylor ES, O'Brien M, et al: Breech delivery: Evaluation of the method of delivery on perinatal results and maternal morbidity . Am J Obstet Gynecol 1979;135:965-973. 6. Tanswell AK, Clubb RA, Smith BT, et al: Individualised continuous distending pressure applied within six hours of delivery in infants with respiratory distress syndrome . Arch Dis Ch ildh 1980;55:33-39.Crossref 7. Lubchenco LO, Hansman C, Dressler M, et al: Intrauterine growth as estimated from live-born birth-weight data at 24 to 42 weeks of gestation . Pediatrics 1963;32:793-800.

Journal

American Journal of Diseases of Children – American Medical Association

Published: Mar 1, 1982

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