Comparison of T-piece resuscitator and self-inflating bag in neonatal resuscitation for extremely preterm infants

Background Extremely preterm infants (<28 weeks gestational age) frequently require positive-pressure ventilation at birth. This study compared resuscitation outcomes between T-piece resuscitators (TPR) and self-inflating bags (SIB) in this population. Methods Cases of extremely preterm infants born at our hospital and transferred to the neonatal intensive care unit between January 1, 2010 and December 31, 2021 were retrospectively collected. According to the application of TPR and SIB during the recovery process, the patients were divided into TPR group (n=111) and SIB group (n=59). The resuscitation process and outcomes were compared between the two groups. Results Among 170 infants (TPR=111, SIB=59), TPR use was associated with significantly lower incidences of pulmonary hemorrhage (17.1% vs. 32.2%, P =0.025) and cerebral white matter injury (26.1% vs. 47.5%, P =0.005). Logistic regression confirmed TPR as a protective factor for both outcomes (OR=0.422 and 0.368, P <0.05). There were no significant differences in the recovery process between the two groups ( P> 0.05). Conclusions The application of a T-piece resuscitator in the resuscitation of extremely preterm infants may be a protective factor for pulmonary haemorrhage and cerebral white matter injury and may be beneficial to the early outcome and long-term prognosis.