Abstract
Objective
To compare the effect of suctioning first or drying first on the composite outcome of hypothermia or respiratory distress in depressed newborns requiring delivery room resuscitation.
Design
Open-label, randomized, parallel-group, controlled trial.
Setting
Delivery room and neonatal intensive care unit of a tertiary-care teaching hospital.
Patients
Depressed newborns (n=154) requiring initial steps of resuscitation at birth.
Intervention
During delivery room resuscitation eligible newborns were randomly allocated to receive either suctioning first or drying first (77 newborns in each group).
Main outcome measure
Composite incidence of hypothermia at admission or respiratory distress at 6 hours of age.
Results
Both groups were comparable with regard to maternal and neonatal characteristics. Composite outcome was similar in both the groups [46 (59.7%) vs 55 (71.4%)] in suctioning first and drying first, respectively [RR (95% CI), 0.84 (0.66–1.05); P=0.13]. Incidence of hypothermia, respiratory distress at admission and oxygen saturation at 6 hours were also similar. On admission to NICU, hypothermia was observed in 26 (33.8%) neonates in suctioning first group and 33 (42.8%) neonates in drying first group but by one hour of age the proportion of hypothermic neonates was 13 (16.9%) and 14 (18.1%), respectively.
Conclusion
In newborns depressed at birth, the sequence of performing initial steps, whether suctioning first or drying first, had comparable effect on composite outcome of hypothermia at admission or respiratory distress at 6 hours of age.
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Contributors
AK, SB: conceptualized and designed the study, coordinated and supervised data collection, drafted the initial manuscript, and reviewed and revised the manuscript; RPY: designed the data collection instruments, collected data, carried out the initial analyses, and reviewed and revised the manuscript; TBS: analyzed the data, and reviewed and revised the manuscript. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.
Ethical clearance
Institutional Ethics Committee of Institute of Medical Sciences, BHU; No. Dean/2014-15/EC/1455 dated 17 October, 2015.
Funding
None
Competing interests
None stated.
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Kumar, A., Yadav, R.P., Basu, S. et al. Suctioning First or Drying First During Delivery Room Resuscitation: A Randomized Controlled Trial. Indian Pediatr 58, 25–29 (2021). https://doi.org/10.1007/s13312-021-2091-z
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DOI: https://doi.org/10.1007/s13312-021-2091-z