Background. Criteria for intubation (I) of ELBWI after birth are not established. Intervention. Change of delivery room strategy: strategy 1 (1994): primary I; strategy 2 (1996). prolonged inflation(15s,20cmH2O) by pharyngeal tube and CPAP in all infants, secondary I only when respiratory failure had occurred. Hypothesis: Mechanical ventilation of ELBWI can be avoided by strategy 2. Subjects. All inborn ELBWI born 1994 and 1996 were grouped: A: I in the delivery room, B: secondary I (RDS); C: no I Statistics: Fisher's exact, Mann-Whitney U test. Results. Group A: n=45(1994)/27(1996); B: 4/14, C: 4/17. When the bias of GA and retardation were eliminated (matched pairs), ventilatory data and outcome did not significantly differ in A (1994) vs A or B(1996). The outcome of C(1996) was the best of all groups .Conclusion. Strategy 2 resulted in a decreased I rate (83 vs 40%). The group of infants who were never ventilated increased (7 vs 27%). Our data do not indicate an impaired outcome in B.Table

Table 1
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