Techniques and Devices to Improve Noninvasive Ventilation in the Delivery Room

Abstract

Research in neonatal resuscitation at birth has been evolving rapidly and accepted knowledge on transition and resuscitative practices are currently being challenged. There has been a shift to more gentle, noninvasive approaches of supporting the preterm newborn. Various pressure-delivering devices and interfaces for noninvasive support are available, but currently no clear recommendations can be given. It now has become apparent that for the most effective noninvasive ventilation strategy at birth, adequate mask ventilation technique is crucial; however, most caregivers are unaware that neonatal mask ventilation can be very difficult and it is often inadequate. The effectiveness of early nasal continuous positive airway pressure may be enhanced by addition of new modes. Such developments might include the use of sustained inflations or nasal intermittent mandatory ventilation. In this review, the current available evidence on technique, devices, and modes of noninvasive ventilation used in the delivery room are discussed.