Oxygen supplementation in the delivery room: T-piece resuscitator cap open or occluded?

J Perinatol. 2019 Aug;39(8):1078-1080. doi: 10.1038/s41372-019-0406-x. Epub 2019 Jun 17.

Abstract

Objective: Updated neonatal resuscitation guidelines for free-flow oxygen administration with a T-piece resuscitator recommend higher gas flow and an open T-piece cap. We aimed to determine the effect of gas inflow rate and cap occlusion on oxygen delivery through a T-piece resuscitator.

Study design: Using a NeoPuff™ T-piece, oxygen inflow was randomly adjusted from 4 to 10 liters per minute (LPM). Gas outflow and oxygen concentration were measured with the T-piece cap open and occluded. Data were analyzed with repeated measures 2-way ANOVA.

Result: Gas outflow was significantly decreased with the T-piece cap open compared with occluded at each inflow rate (p < 0.001). There was no difference in oxygen concentration of the outflow gas.

Conclusion: Gas flow from the T-piece is affected by the inflow rate and cap occlusion but oxygen concentration is not. To deliver 5 LPM of free-flow oxygen with the cap open, a minimum of 8 LPM gas inflow is required.

MeSH terms

  • Continuous Positive Airway Pressure / instrumentation
  • Continuous Positive Airway Pressure / methods
  • Delivery Rooms
  • Equipment Design
  • Humans
  • Infant, Newborn
  • Oxygen Inhalation Therapy / instrumentation*
  • Oxygen Inhalation Therapy / methods
  • Resuscitation / methods*