Original ArticleInitial Respiratory Support with Cold, Dry Gas versus Heated Humidified Gas and Admission Temperature of Preterm Infants
Section snippets
Methods
A nonblinded, randomized controlled trial was performed in 2 centers: Middlemore Hospital, Auckland, New Zealand (NZ), and Leiden University Medical Center, Leiden, The Netherlands (NL). Preterm infants <32 weeks' gestation that were deemed by the clinical team to require respiratory support at delivery were eligible for the study. Infants were randomized to either unconditioned, cold, dry gas, or HHG during respiratory support at birth and during transport. Initial respiratory support was
Results
Analysis was performed on 103 infants who received cold, dry gas and 100 who received HHG during respiratory support; 105 infants were entered in NZ and 98 in NL (Figure 1). There were no differences in baseline characteristics (Table I). The median humidifier temperature as recorded in NZ was 36.7°C (IQR 36.2-37.0°C) before birth, and there were no instances in which the humidifier ran dry, nor was there loss of gas flow/pressure through the circuit. Two infants who were randomized did not
Discussion
In this randomized controlled trial, preterm infants receiving respiratory support via a T-piece resuscitator in the humidification arm were supplied with HHG from birth.
We found that there were more normothermic infants in the HHG group on admission to the neonatal unit. The reduction in hypothermia in the trial was of the same magnitude (35%) as the previous observational study.7 In addition, we observed that humidification was more effective in preventing more severe degrees of hypothermia,
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Fisher & Paykel Healthcare (Auckland, New Zealand) provided partial funding for a research nurse and humidifier circuits for the study. A.teP. is supported by The Netherlands Organisation for Health Research and Development, part of the Innovational Research Incentives Scheme Veni-Vidi-Vici (91612027). The authors declare no conflicts of interest.
Registered with the ANZCTR (Australia New Zealand Clinical Trials Registry): 12609000694213.