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Effect on Survival

John H. Drew, MD, FRACP

Am J Dis Child. 1982;136(3):207-210.

Abstract
• Two policies of resuscitation at birth were compared: mandatory intubation and stabilization of the airway with continuous positive airway pressure (the electively intubated group), and intubation used according to clinical judgment (selectively intubated group), in infants with a birth weight of 501 to 1,500 g. Of 69 infants electively intubated, 53 (77%) survived; of 96 infants selectively intubated, 49 (51%) survived. Benefits from elective intubation were a higher five-minute Apgar score, less metabolic acidosis within four hours of birth, and fewer ventilatory requirements. Pneumothorax occurred in 33% of the selectively intubated infants and 20% of those electively intubated. Bronchopulmonary dysplasia occurred in 14% of infants electively intubated and 8% of those in the selectively intubated group; retrolental fibroplasia occurred in 16% and 12.2%, respectively. Long-term study showed that laryngeal problems were minimal, occurring in only one of the electively intubated infants.

(Am J Dis Child 1982;136:207-210)

Author Affiliations
From the Department of Obstetrics and Gynecology, University of Melbourne and the Mercy Maternity Hospital, Victoria, Australia.

Footnotes
Reprint requests to Mercy Maternity Hospital, Clarendon Street, East Melbourne, Victoria, Australia 410261 (Dr Drew).

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