Physiological-based cord clamping in preterm infants using a new purpose-built resuscitation table: a feasibility study.

A new interesting article has been published in Arch Dis Child Fetal Neonatal Ed. 2019 Jul;104(4):F396-F402. doi: 10.1136/archdischild-2018-315483. Epub 2018 Oct 3. and titled:

Physiological-based cord clamping in preterm infants using a new purpose-built resuscitation table: a feasibility study.

Authors of this article are:

Brouwer E#, Knol R#, Vernooij ASN, van den Akker T, Vlasman PE, Klumper FJCM, DeKoninck P, Polglase GR, Hooper SB, Te Pas AB.

A summary of the article is shown below:

OBJECTIVE: Physiological-based cord clamping (PBCC) led to a more stable cardiovascular adaptation and better oxygenation in preterm lambs, but in preterm infants, this approach has been challenging. Our aim was to assess the feasibility of PBCC, including patterns of oxygen saturation (SpO2) and heart rate (HR) during stabilisation in preterm infants using a new purpose-built resuscitation table.DESIGN: Observational study.SETTING: Tertiary referral centre, Leiden University Medical Centre, The Netherlands.PATIENTS: Infants born below 35 weeks’ gestational age.INTERVENTIONS: Infants were stabilised on a new purpose-built resuscitation table (Concord), provided with standard equipment needed for stabilisation. Cord clamping was performed when the infant was stable (HR >100 bpm, spontaneous breathing on continuous positive airway pressure with tidal volumes >4 mL/kg, SpO2 ≥25th percentile and fraction of inspired oxygen (FiO2) <0.4).RESULTS: Thirty-seven preterm infants were included; mean (SD) gestational age of 30.9 (2.4) weeks, birth weight 1580 (519) g. PBCC was successful in 33 infants (89.2%) and resulted in median (IQR) cord clamping time of 4:23 (3:00-5:11) min after birth. There were no maternal or neonatal adverse events. In 26/37 infants, measurements were adequate for analysis. HR was 113 (81-143) and 144 (129-155) bpm at 1 min and 5 min after birth. SpO2 levels were 58%(49%-60%) and 91%(80%-96%)%), while median FiO2 given was 0.30 (0.30-0.31) and 0.31 (0.25-0.97), respectively.CONCLUSION: PBCC in preterm infants using the Concord is feasible. HR remained stable, and SpO2 quickly increased with low levels of oxygen supply.TRIAL REGISTRATION NUMBER: NTR6095, results.© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
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This article is a good source of information and a good way to become familiar with topics such as: Adaptation, Physiological;Constriction;Feasibility Studies;Female;Heart Rate;Humans;Infant, Newborn;Infant, Premature;Male;Netherlands;Oximetry;Resuscitation;Umbilical Cord.

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