A randomized trial comparing oxygen delivery on intermittent positive pressure with nasal cannulae versus facial mask in neonatal primary resuscitation

Aim: To compare, in a prospective clinical trial, oxygen delivery on intermittent positive pressure with nasal cannulae versus facial mask in primary resuscitation of the newborn with moderate asphyxia. Methods: 617 neonates with moderate asphyxia at birth were randomized: 303 were resuscitated by oxygen on intermittent positive pressure with nasal cannuale and 314 neonates by mask. Resuscitation followed the Neonatal Resuscitation Program guidelines of the American Academy of Pediatrics, 3rd edition. Results: Resuscitation through the nasal route less frequently requires chest compressions and intubations (26 neonates needed chest compression and 20 needed intubation out of 314 resuscitated by mask; five neonates needed chest compression and two needed intubation out of 303 resuscitated by nasal cannulae). Apgar scores, admission rates to neonatal intensive care units, air-leak syndromes, birthweight, gestational age, use of prenatal steroids and deaths did not differ between groups. Conclusion: Oxygen delivery on intermittent positive pressure with nasal cannulae in primary resuscitation of the newborn with moderate asphyxia is a less aggressive and potentially advantageous alternative to the traditional oral route.