Recent discussions
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helenilce cosra
Em RN termo e pré-termo tardio, somos favoráveis ao estímulo tátil. Em RN pre-termo com IG<32 sem. não. -
Helenilce Costa
Para o RN de termo usualmente não usamos CPAP precoce durante a reanimação na sala de parto. -
Marcos Silva
Tactile stimulation does not have a single, safe parameter to use as a safe measure. Despite a reasonable indication, it can act as a factor that brings confusion in the recognition of its best application as well as delay in the application of PPV. -
Murray Hinder
Design of device used to provide CPAP may be an important consideration when providing treatment to term infants. Bench testing of TPR devices show that high expiratory resistance of the CPAP/PEEP valve can contribute to incomplete expiration (autoPEEP) during PPV(1-3) and increased work of breathing during CPAP (4, 5) with near term and term lung compliances. RCT’s cited in Consensus of Science statement use devices with high expiratory resistance to provide CPAP, (Smithhart 2019 e20190756 Neopuff TPR) and (Hishikawa 2015 F382; Hishikawa 2016 Mercury Medical Hyper Inflation system with flow restrictor) (personal communication Dr Hishikawa 2016). More research on device suitability for provision of CPAP for term infants is needed. 1. Drevhammar T, Falk M, Donaldsson S, Tracy M, Hinder M. Neonatal Resuscitation With T-Piece Systems: Risk of Inadvertent PEEP Related to Mechanical Properties. Front Pediatr. 2021;9:663249. 2. Hinder M, McEwan A, Drevhammer T, Donaldson S, Tracy MB. T-piece resuscitators: how do they compare? Arch Dis Child Fetal Neonatal Ed. 2019;104(2):F122-F7. 3. Hinder M, Jani P, Priyadarshi A, McEwan A, Tracy M. Neopuff T-piece resuscitator: does device design affect delivered ventilation? Arch Dis Child Fetal Neonatal Ed. 2017;102(3):F220-F4. 4. Drevhammar T, Nilsson K, Zetterstrom H, Jonsson B. Comparison of seven infant continuous positive airway pressure systems using simulated neonatal breathing. PediatrCrit Care Med. 2012;13(2):e113-e9. 5. Donaldsson S, Drevhammar T, Taittonen L, Klemming S, Jonsson B. Initial stabilisation of preterm infants: a new resuscitation system with low imposed work of breathing for use with face mask or nasal prongs. Arch Dis Child Fetal Neonatal Ed. 2017;102(3):F203-F7. -
Carolyn Zelop
Well done Would change title to clarify newborn monitoring not to be confused with fetal -
Gislayne Nieto
I think we have already performed the tactile stimulus during the drying the baby .I am worried about changing the technique again and delay in starting the VPP -
Gislayne Nieto
We have no experience in our service. we use the laryngeal mask in new borns over 34 weeks with intubation difficulty only -
Gislayne Nieto
In our service we use CPAP in the delivery room in newborns > 34 weeks with mild to moderate distress for up to 1 hour. If they do not improve, they are admitted to the ICU .We are trying to analyze our data regarding the success and failure of this technique in our service -
Ana Paula Claro
I agree using tactile stimulation at same time with positive pressure ventilation. Another person can do it, when the doctor is doing PPV. I agree using tactile stimulation with babies above 34 weeks. -
Gabriel Variane
That's a very interesting discussion. Previous studies have looked at the benefits of using CPAP in the delivery room for preterm infants, but there is still a lack of evidence of the real benefits of CPAP in the delivery room for spontaneously breathing late preterm and term newborn infants with respiratory distress. We routinely use early CPAP in our center for both term and preterm infants with respiratory distress.