Decreasing delivery room CPAP-associated pneumothorax at ≥35-week gestational age

Edward F. Stocks, Mambarambath Jaleel, William Smithhart, Patti J. Burchfield, Anita Thomas, Kate Louise M. Mangona, Vishal Kapadia, Myra Wyckoff, Venkatakrishna Kakkilaya, Shelby Brenan, L. Steven Brown, Christopher Clark, David B. Nelson, Luc P. Brion

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: We previously reported an increase in pneumothorax after implementing delivery room (DR) continuous positive airway pressure (CPAP) for labored breathing or persistent cyanosis in ≥35-week gestational age (GA) neonates unexposed to DR-positive pressure ventilation (DR-PPV). We hypothesized that pneumothorax would decrease after de-implementing DR-CPAP in those unexposed to DR-PPV or DR-O2 supplementation (DR-PPV/O2). Study design: In a retrospective cohort excluding DR-PPV the primary outcome was DR-CPAP-related pneumothorax (1st chest radiogram, 1st day of life). In a subgroup treated by the resuscitation team and admitted to the NICU, the primary outcome was DR-CPAP-associated pneumothorax (1st radiogram, no prior PPV) without DR-PPV/O2. Results: In the full cohort, occurrence of DR-CPAP-related pneumothorax decreased after the intervention (11.0% vs 6.0%, P < 0.001). In the subgroup, occurrence of DR-CPAP-associated pneumothorax decreased after the intervention (1.4% vs. 0.06%, P < 0.001). Conclusion: The occurrence of CPAP-associated pneumothorax decreased after avoiding DR-CPAP in ≥35-week GA neonates without DR-PPV/O2.

Original languageEnglish (US)
JournalJournal of Perinatology
DOIs
StateAccepted/In press - 2022

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Obstetrics and Gynecology

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