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A Randomized Trial of Conditioned or Unconditioned Gases for Stabilizing Preterm Infants at Birth
Lorraine McGrory1, Louise S Owen2, Marta Thio2
1Department of Newborn Research, The Royal Women's Hospital, Melbourne, Australia; Department of Child Health, The University of Dundee, Dundee, United Kingdom.
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.
