• Archana Jayaram, Adam Sima, Gail Barker, and Leroy R Thacker.
• Division of Neonatal-Perinatal Medicine, Children's Hospital of Richmond, Virginia Commonwealth University, Richmond, VA 23298-0276, USA
• Respir Care. 2013 Jul 1;58(7):1233-6.

BackgroundManual ventilation in the delivery room is provided with devices such as self-inflating bags (SIBs), flow-inflating bags, and T-piece resuscitators.ObjectiveTo compare the effect of type of manual ventilation device on overall response to resuscitation among preterm neonates born at < 35 weeks gestation.MethodsRetrospective 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.ResultsWe 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).ConclusionsAlthough 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.

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