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allied
academies
September 20-22, 2017 | Toronto, Canada
10
TH
AMERICAN PEDIATRICS HEALTHCARE &
PEDIATRIC INFECTIOUS DISEASES CONGRESS
Pediatric Healthcare & Pediatric Infections 2017
Background:
It is recommended to delay umbilical cord
clamping for at least 60 seconds in preterm infants to
facilitate placental transfusion (PT). However, compromised
neonates receive immediate cord clamping as they are
deemed to require resuscitation. These babies may benefit
from both PT and resuscitation; this dyad is not well studied.
Objective:
To study the feasibility of initiating resuscitative
support during PT for up to 90 seconds in preterm infants.
Design/Methods:
We designed and built a mobile battery-
powered resuscitation platform (INSPiRe) that contains a
warm gel mattress, oxygen and air tanks, oxygen blender,
T-piece resuscitator, pulse oximeter (PO), and electrical
suction device. Resuscitative care included positioning
neonate in a supine position, opening the airway, suctioning
if necessary, drying, and stimulation. Thermoregulation was
maintained using a hat, warme blankets and gel mattress.
Respiratory support was initiated at 30 seconds following
Neonatal Resuscitation Program guidelines. Preductal
oxygen saturation (SpO2) was continuously monitored.
Heart rate was documented via auscultation at 30, 60 and 90
seconds. Umbilical cord clamping was done at 90 seconds.
The baby and the platform were mobilized from mother’s
bedside to the radiant warmer in the same room by one
provider, while another provider maintained the respiratory
support. Axillary temperature was obtained, once the
baby is transferred to the radiant warmer. Resuscitation
interventions and management during first 24 hours were
documented.
Results:
Fourteen preterm infants (26–36 weeks) born
vaginally received resuscitative care using INSPiRe during PT
for 90 seconds. Eleven neonates received CPAP on INSPiRE,
two received PPV. Eleven infants received ongoing cpap in
the NICU. Preductal Sp02 was >70% at one minute of age
and no less than 78% at 90 seconds. One neonate had a
temperature <36.5 (35.9). No neonate required inotropes or
fluid volume resuscitation in the following 24 hours. None of
them had IVH.
e:
leigh.irvine@albertahealthservices.caIntegrated neonatal support on placental circulation with resuscitation (INSPiRe): A feasibility study
Leigh Irvine, Ayman Abou Mehrem, Derek Kowal, Amuchou Soraisham, Stephanie Cooper, Amelie Stritzke, Yacov Rabi, Andrei Harabor, Nalini Singhal
and
Sumesh Thomas
University of Calgary, Canada