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  • Original Article
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Mask ventilation with two different face masks in the delivery room for preterm infants: a randomized controlled trial

Journal of Perinatology volume 35, pages 464–468 (2015)Cite this article

Subjects

Abstract

Background:

If an infant fails to initiate spontaneous breathing after birth, international guidelines recommend a positive pressure ventilation (PPV). However, PPV by face mask is frequently inadequate because of leak between the face and mask. Despite a variety of available face masks, none have been prospectively compared in a randomized fashion. We aimed to evaluate and compare leak between two commercially available round face masks (Fisher & Paykel (F&P) and Laerdal) in preterm infants <33 weeks gestational age in the delivery room.

Methods:

Infants born at the Royal Alexandra Hospital from April to September 2013 at <33 weeks gestational age who received mask PPV in the delivery room routinely had a flow sensor placed between the mask and T-piece resuscitator. Infants were randomly assigned to receive PPV with either a F&P or Laerdal face mask. All resuscitators were trained in the use of both face masks. We compared mask leak, airway pressures, tidal volume and ventilation rate between the two groups.

Results:

Fifty-six preterm infants (n=28 in each group) were enrolled; mean±s.d. gestational age 28±3 weeks; birth weight 1210±448 g; and 30 (52%) were male. Apgar scores at 1 and 5 min were 5±3 and 7±2, respectively. Infants randomized to the F&P face mask and Laerdal face mask had similar mask leak (30 (25–38) versus 35 (24–46)%, median (interquartile range), respectively, P=0.40) and tidal volume (7.1 (4.9–8.9) versus 6.6 (5.2–8.9) ml kg−1, P=0.69) during PPV. There were no significant differences in ventilation rate, inflation time or airway pressures between groups.

Conclusion:

The use of either face mask during PPV in the delivery room yields similar mask leak in preterm infants <33 weeks gestational age.

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Acknowledgements

We thank the parents and infants agreeing to be part of the study and the Resuscitation-Stabilization-Triage team at the Royal Alexandra Hospital for their assistance and support of the study. GMS is a recipient of the Heart and Stroke Foundation/University of Alberta Professorship of Neonatal Resuscitation. F&P (Fisher & Paykel Healthcare, Auckland, New Zealand) provided the Fisher & Paykel face masks for the study. No study sponsor or company that manufactures markets or sells any equipment used in the study had involvement in study design, data collection or interpretation or the decision to present or publish the results.

Author Contributions

Conception and design: GMS, KA, PYC. Collection and assembly of data: DC, QM, GMS, KA, GP, MOR, PYC. Analysis and interpretation of the data: DC, QM, GMS, KA, GP, MOR, PYC. Drafting of the article: DC, QM, GMS, KA, GP, MOR, PYC. Critical revision of the article for important intellectual content: DC, QM, GMS, KA, GP, MOR, PYC. Final approval of the article: DC, QM, GMS, KA, GP, MOR, PYC.

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Authors and Affiliations

  1. Centre for the Studies of Asphyxia and Resuscitation, Neonatal Research Unit, Royal Alexandra Hospital, Edmonton, AB, Canada,

    D Cheung, Q Mian, P-Y Cheung, M O'Reilly, K Aziz, S van Os, G Pichler & G M Schmölzer

  2. Department of Pediatrics, University of Alberta, Edmonton, AB, Canada,

    P-Y Cheung, M O'Reilly, K Aziz, G Pichler & G M Schmölzer

  3. Division of Neonatology, Department of Pediatrics, Medical University, Graz, Austria

    G Pichler & G M Schmölzer

Authors
  1. D Cheung
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  2. Q Mian
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  3. P-Y Cheung
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  4. M O'Reilly
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  5. K Aziz
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  6. S van Os
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  7. G Pichler
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  8. G M Schmölzer
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Corresponding author

Correspondence to G M Schmölzer.

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The authors declare no conflict of interest.

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Cheung, D., Mian, Q., Cheung, PY. et al. Mask ventilation with two different face masks in the delivery room for preterm infants: a randomized controlled trial. J Perinatol 35, 464–468 (2015). https://doi.org/10.1038/jp.2015.8

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