Optimizing noninvasive respiratory support during postnatal stabilization: video-based analysis of airway maneuvers and their effects

Abstract

Objective

Noninvasive respiratory support during postnatal transition may be challenging. Thus, we aimed to analyze frequency and effects of maneuvers to improve noninvasive respiratory support in neonates immediately after birth.

Materials and methods

We included neonates born between September 2009 and January 2015 who were video recorded as part of prospective observational studies and required noninvasive respiratory support during the first 15 min after birth. Maneuvers to improve respiratory support were assessed by video analysis. Vital parameter measurement using pulse oximetry and near-infrared spectroscopy was supplemented by respiratory function monitoring.

Results

One-hundred forty-three of 653 eligible neonates (21.9%) required respiratory support. Video recordings were analyzed in 76 preterm and 58 term neonates, showing airway maneuvers in 105 of them (78.4%). Repositioning of the face mask was the most common maneuver (56.9%). We observed a median of three maneuvers (0–22) in preterm and a median of two maneuvers (0–13) in term neonates (p = .01). Regional cerebral tissue oxygen saturation was significantly higher during the 60 s after the first airway maneuver.

Conclusion

Maneuvers to improve respiratory support are commonly required during neonatal resuscitation, with a higher incidence in preterm neonates. The first airway maneuver was associated with an improvement of cerebral tissue oxygenation.

Keywords:

• Neonate
• resuscitation
• ventilation
• airway maneuver
• “MR SOPA”
• cerebral oxygenation

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

Research data is confidential. Deidentified participant data will be made available to researchers only upon reasonable request to the study authors.