PREM X HEATED HUMIDFD GASES

A Randomized Trial of Conditioned or Unconditioned Gases for Stabilizing Preterm Infants at Birth

Lorraine McGrory, MBChBCorrespondence information about the author MBChB Lorraine McGroryEmail the author MBChB Lorraine McGroryEmail the author MBChB Lorraine McGrory

, 

Louise S. Owen, MD

, 

Marta Thio, PhD

, 

Jennifer A. Dawson, PhD

, 

Anthony R. Rafferty, PhD

, 

Atul Malhotra, MD

, 

Peter G. Davis, MD

, 

C. Omar F. Kamlin, DMedSci

Objective

To determine whether the use of heated-humidified gases for respiratory support during the stabilization of infants <30 weeks of gestational age (GA) in the delivery room reduces rates of hypothermia on admission to the neonatal intensive care unit (NICU).

Study design

A multicenter, unblinded, randomized trial was conducted in Melbourne, Australia, between February 2013 and June 2015. Infants <30 weeks of GA were randomly assigned to receive either heated-humidified gases or unconditioned gases during stabilization in the delivery room and during transport to NICU. Infants born to mothers with pyrexia >38°C were excluded. Primary outcome was rate of hypothermia on NICU admission (rectal temperature <36.5°C).

Results

A total of 273 infants were enrolled. Fewer infants in the heated-humidified group were hypothermic on admission to NICU (36/132 [27%]) compared with controls (61/141 [43%], P < .01). There was no difference in rates of hyperthermia (>37.5°C); 20% (27/132) in the heated-humidified group compared with 16% (22/141) in the controls (P = .30). There were no differences in mortality or respiratory outcomes.

Conclusions

The use of heated-humidified gases in the delivery room significantly reduces hypothermia on admission to NICU in preterm infants, without increased risk of hyperthermia.