• Janneke Dekker, Stuart B Hooper, Tessa Martherus, Sophie J E Cramer, Nan van Geloven, and Arjan B Te Pas.
• Division of Neonatology, Department of Pediatrics, Leiden University Medical Center, Leiden, The Netherlands. Electronic address: j.dekker@lumc.nl.
• Resuscitation. 2018 Jun 1; 127: 37-43.

AimTo evaluate the direct effect of repetitive tactile stimulation on breathing effort of preterm infants at birth.MethodsThis randomized controlled trial compared the effect of repetitive stimulation on respiratory effort during the first 4 min after birth with standard stimulation based on clinical indication in preterm infants with a gestational age of 27-32 weeks. All details of the stimulation performed were noted. The main study parameter measured was respiratory minute volume, other study parameters assessed measures of respiratory effort; tidal volumes, rate of rise to maximum tidal volumes, percentage of recruitment breaths, and oxygenation of the infant.ResultsThere was no significant difference in respiratory minute volume in the repetitive stimulation group when compared to the standard group. Oxygen saturation was significantly higher (87.6 ± 3.3% vs 81.7 ± 8.7%, p = .01) while the amount of FiO2 given during transport to the NICU was lower (28.2 (22.8-35.0)% vs 33.6 (29.4-44.1)%, p = .04). There was no significant difference in administration of positive pressure ventilation (52% vs 78%, p = .13), or the duration of ventilation (median (IQR) time 8 (0-118)s vs 35 (13-131)s, p = .23). Caregivers decided less often to administer caffeine in the delivery room to stimulate breathing in the repetitive stimulation group (10% vs 39%, p = .036).ConclusionAlthough the increase in respiratory effort during repetitive stimulation did not reach significance, oxygenation significantly improved with a lower level of FiO2 at transport to the NICU. Repetitive tactile stimulation could be of added value to improve breathing effort at birth.Copyright © 2018 The Authors. Published by Elsevier B.V. All rights reserved.

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