T-piece resuscitator versus self-inflating bag for preterm resuscitation: an institutional experience.

BACKGROUND Manual ventilation in the delivery room is provided with devices such as self-inflating bags (SIBs), flow-inflating bags, and T-piece resuscitators. OBJECTIVE To compare the effect of type of manual ventilation device on overall response to resuscitation among preterm neonates born at < 35 weeks gestation. METHODS Retrospective data were collected in 2 time periods. Primary outcome was overall response to resuscitation, as measured by Apgar score. Secondary outcomes were incidence of air leaks, need for chest compressions/epinephrine, need for intubation, and surfactant use. RESULTS We identified 294 resuscitations requiring ventilation. SIB was used for 135 neonates, and T-piece was used for 159 neonates. There was no significant difference between the 1-min and 5-min Apgar scores between SIB and T-piece (P = .77 and P = .11, respectively), nor were there significant differences in secondary outcomes. The rate of rise of Apgar score was higher, by 0.47, with T-piece, compared to SIB (95% CI 0.08-0.87, P = .02). CONCLUSIONS Although some manikin studies favor T-piece for providing reliable and consistent pressures, our experience did not indicate significant differences in effectiveness of resuscitation between the T-piece and SIB in preterm resuscitations.