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

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...

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Veröffentlicht in:Journal of perinatology 2022-06, Vol.42 (6), p.761-768
Hauptverfasser: Stocks, Edward F., Jaleel, Mambarambath, Smithhart, William, Burchfield, Patti J., Thomas, Anita, Mangona, Kate Louise M., Kapadia, Vishal, Wyckoff, Myra, Kakkilaya, Venkatakrishna, Brenan, Shelby, Brown, L. Steven, Clark, Christopher, Nelson, David B., Brion, Luc P.
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container_end_page 768
container_issue 6
container_start_page 761
container_title Journal of perinatology
container_volume 42
creator Stocks, Edward F.
Jaleel, Mambarambath
Smithhart, William
Burchfield, Patti J.
Thomas, Anita
Mangona, Kate Louise M.
Kapadia, Vishal
Wyckoff, Myra
Kakkilaya, Venkatakrishna
Brenan, Shelby
Brown, L. Steven
Clark, Christopher
Nelson, David B.
Brion, Luc P.
description 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-O 2 supplementation (DR-PPV/O 2 ). 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/O 2 . Results In the full cohort, occurrence of DR-CPAP-related pneumothorax decreased after the intervention (11.0% vs 6.0%, P  
doi_str_mv 10.1038/s41372-022-01334-4
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Steven ; Clark, Christopher ; Nelson, David B. ; Brion, Luc P.</creator><creatorcontrib>Stocks, Edward F. ; Jaleel, Mambarambath ; Smithhart, William ; Burchfield, Patti J. ; Thomas, Anita ; Mangona, Kate Louise M. ; Kapadia, Vishal ; Wyckoff, Myra ; Kakkilaya, Venkatakrishna ; Brenan, Shelby ; Brown, L. Steven ; Clark, Christopher ; Nelson, David B. ; Brion, Luc P.</creatorcontrib><description>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-O 2 supplementation (DR-PPV/O 2 ). 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/O 2 . Results In the full cohort, occurrence of DR-CPAP-related pneumothorax decreased after the intervention (11.0% vs 6.0%, P  &lt; 0.001). In the subgroup, occurrence of DR-CPAP-associated pneumothorax decreased after the intervention (1.4% vs. 0.06%, P  &lt; 0.001). Conclusion The occurrence of CPAP-associated pneumothorax decreased after avoiding DR-CPAP in ≥35-week GA neonates without DR-PPV/O 2 .</description><identifier>ISSN: 0743-8346</identifier><identifier>EISSN: 1476-5543</identifier><identifier>DOI: 10.1038/s41372-022-01334-4</identifier><identifier>PMID: 35173286</identifier><language>eng</language><publisher>New York: Nature Publishing Group US</publisher><subject>692/700/1720 ; 692/700/565 ; Continuous positive airway pressure ; Continuous Positive Airway Pressure - adverse effects ; Cyanosis ; Delivery Rooms ; Electronic health records ; Female ; Gestational Age ; Humans ; Infant, Newborn ; Intervention ; Medicine ; Medicine &amp; Public Health ; Neonates ; Newborn babies ; Nurse practitioners ; Pediatric Surgery ; Pediatrics ; Pneumothorax ; Pneumothorax - etiology ; Pregnancy ; Premature babies ; Respiration ; Respiratory Distress Syndrome, Newborn - therapy ; Resuscitation ; Retrospective Studies ; Subgroups ; Ventilators</subject><ispartof>Journal of perinatology, 2022-06, Vol.42 (6), p.761-768</ispartof><rights>The Author(s), under exclusive licence to Springer Nature America, Inc. 2022</rights><rights>2022. 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Steven</creatorcontrib><creatorcontrib>Clark, Christopher</creatorcontrib><creatorcontrib>Nelson, David B.</creatorcontrib><creatorcontrib>Brion, Luc P.</creatorcontrib><title>Decreasing delivery room CPAP-associated pneumothorax at ≥35-week gestational age</title><title>Journal of perinatology</title><addtitle>J Perinatol</addtitle><addtitle>J Perinatol</addtitle><description>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-O 2 supplementation (DR-PPV/O 2 ). 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/O 2 . Results In the full cohort, occurrence of DR-CPAP-related pneumothorax decreased after the intervention (11.0% vs 6.0%, P  &lt; 0.001). In the subgroup, occurrence of DR-CPAP-associated pneumothorax decreased after the intervention (1.4% vs. 0.06%, P  &lt; 0.001). Conclusion The occurrence of CPAP-associated pneumothorax decreased after avoiding DR-CPAP in ≥35-week GA neonates without DR-PPV/O 2 .</description><subject>692/700/1720</subject><subject>692/700/565</subject><subject>Continuous positive airway pressure</subject><subject>Continuous Positive Airway Pressure - adverse effects</subject><subject>Cyanosis</subject><subject>Delivery Rooms</subject><subject>Electronic health records</subject><subject>Female</subject><subject>Gestational Age</subject><subject>Humans</subject><subject>Infant, Newborn</subject><subject>Intervention</subject><subject>Medicine</subject><subject>Medicine &amp; Public Health</subject><subject>Neonates</subject><subject>Newborn babies</subject><subject>Nurse practitioners</subject><subject>Pediatric Surgery</subject><subject>Pediatrics</subject><subject>Pneumothorax</subject><subject>Pneumothorax - etiology</subject><subject>Pregnancy</subject><subject>Premature babies</subject><subject>Respiration</subject><subject>Respiratory Distress Syndrome, Newborn - therapy</subject><subject>Resuscitation</subject><subject>Retrospective Studies</subject><subject>Subgroups</subject><subject>Ventilators</subject><issn>0743-8346</issn><issn>1476-5543</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNp9kc1u1DAUhS1ERYeBF2CBIrFhE2r7-i8bpGrKT6VKrQSsLce5SVOSeLCTQh-BB-HFeBI8TCk_CxbWXZzvHt-jQ8gTRl8wCuYoCQaal5TnxwBEKe6RFRNalVIKuE9WVAsoDQh1SB6mdEXpTtQPyCFIpoEbtSLvTtBHdKmfuqLBob_GeFPEEMZic3F8UbqUgu_djE2xnXAZw3wZovtSuLn4_vUbyPIz4seiwzS7uQ-TGwrX4SNy0Loh4ePbuSYfXr96v3lbnp2_Od0cn5VeaDGXFaet9pLW0qBTBioKbSUq4IDKtyBkpWvHasM5gJYeVO2rpqlZ20jlRM6-Ji_3vtulHrHxOM3RDXYb-9HFGxtcb_9Wpv7SduHaGiMBqMkGz28NYvi05BB27JPHYXAThiVZrnhlFFVcZfTZP-hVWGIOvKO0kJrJfOea8D3lY0gpYnt3DKN215ndd2ZzZ_ZnZ1bkpad_xrhb-VVSBmAPpCxNHcbff__H9gfOCaKl</recordid><startdate>20220601</startdate><enddate>20220601</enddate><creator>Stocks, Edward F.</creator><creator>Jaleel, Mambarambath</creator><creator>Smithhart, William</creator><creator>Burchfield, Patti J.</creator><creator>Thomas, Anita</creator><creator>Mangona, Kate Louise M.</creator><creator>Kapadia, Vishal</creator><creator>Wyckoff, Myra</creator><creator>Kakkilaya, Venkatakrishna</creator><creator>Brenan, Shelby</creator><creator>Brown, L. 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Steven</au><au>Clark, Christopher</au><au>Nelson, David B.</au><au>Brion, Luc P.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Decreasing delivery room CPAP-associated pneumothorax at ≥35-week gestational age</atitle><jtitle>Journal of perinatology</jtitle><stitle>J Perinatol</stitle><addtitle>J Perinatol</addtitle><date>2022-06-01</date><risdate>2022</risdate><volume>42</volume><issue>6</issue><spage>761</spage><epage>768</epage><pages>761-768</pages><issn>0743-8346</issn><eissn>1476-5543</eissn><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-O 2 supplementation (DR-PPV/O 2 ). 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/O 2 . Results In the full cohort, occurrence of DR-CPAP-related pneumothorax decreased after the intervention (11.0% vs 6.0%, P  &lt; 0.001). In the subgroup, occurrence of DR-CPAP-associated pneumothorax decreased after the intervention (1.4% vs. 0.06%, P  &lt; 0.001). Conclusion The occurrence of CPAP-associated pneumothorax decreased after avoiding DR-CPAP in ≥35-week GA neonates without DR-PPV/O 2 .</abstract><cop>New York</cop><pub>Nature Publishing Group US</pub><pmid>35173286</pmid><doi>10.1038/s41372-022-01334-4</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0001-7862-5869</orcidid><orcidid>https://orcid.org/0000-0002-6139-0132</orcidid><oa>free_for_read</oa></addata></record>
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subjects 692/700/1720
692/700/565
Continuous positive airway pressure
Continuous Positive Airway Pressure - adverse effects
Cyanosis
Delivery Rooms
Electronic health records
Female
Gestational Age
Humans
Infant, Newborn
Intervention
Medicine
Medicine & Public Health
Neonates
Newborn babies
Nurse practitioners
Pediatric Surgery
Pediatrics
Pneumothorax
Pneumothorax - etiology
Pregnancy
Premature babies
Respiration
Respiratory Distress Syndrome, Newborn - therapy
Resuscitation
Retrospective Studies
Subgroups
Ventilators
title Decreasing delivery room CPAP-associated pneumothorax at ≥35-week gestational age
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