Suctioning First or Drying First During Delivery Room Resuscitation: A Randomized Controlled Trial.

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 new-borns 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.