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dc.contributor.authorDonaldsson, Snorri
dc.contributor.authorDrevhammar, Thomas
dc.contributor.authorLi, Yinghua
dc.contributor.authorBartocci, Marco
dc.contributor.authorRettedal, Siren Irene
dc.contributor.authorLundberg, Fredrik
dc.contributor.authorOdelberg-Johnson, Per
dc.contributor.authorSzczapa, Tomasz
dc.contributor.authorThordarson, Thordur
dc.contributor.authorPilypiene, Ingrida
dc.contributor.authorThorkelsson, Thordur
dc.contributor.authorSoderstrom, Lars
dc.contributor.authorChijenas, Vladimiras
dc.contributor.authorJonsson, Baldvin
dc.date.accessioned2021-10-18T15:29:36Z
dc.date.available2021-10-18T15:29:36Z
dc.date.issued2021-09
dc.date.submitted2021-10
dc.identifier.citationDonaldsson S, Drevhammar T, Li Y, Bartocci M, Rettedal SI, Lundberg F, Odelberg-Johnson P, Szczapa T, Thordarson T, Pilypiene I, Thorkelsson T, Soderstrom L, Chijenas V, Jonsson B; CORSAD Trial Investigators. Comparison of Respiratory Support After Delivery in Infants Born Before 28 Weeks' Gestational Age: The CORSAD Randomized Clinical Trial. JAMA Pediatr. 2021 Sep 1;175(9):911-918. doi: 10.1001/jamapediatrics.2021.1497.en_US
dc.identifier.pmid34125148
dc.identifier.doi10.1001/jamapediatrics.2021.1497
dc.identifier.urihttp://hdl.handle.net/2336/621906
dc.descriptionTo access publisher's full text version of this article click on the hyperlink belowen_US
dc.description.abstractImportance: Establishing stable breathing is a key event for preterm infants after birth. Delivery of pressure-stable continuous positive airway pressure and avoiding face mask use could be of importance in the delivery room. Objective: To determine whether using a new respiratory support system with low imposed work of breathing and short binasal prongs decreases delivery room intubations or death compared with a standard T-piece system with a face mask. Design, setting, and participants: In this unblinded randomized clinical trial, mothers threatening preterm delivery before week 28 of gestation were screened. A total of 365 mothers were enrolled, and 250 infants were randomized before birth and 246 liveborn infants were treated. The trial was conducted in 7 neonatal intensive care units in 5 European countries from March 2016 to May 2020. The follow-up period was 72 hours after intervention. Interventions: Infants were randomized to either the new respiratory support system with short binasal prongs (n = 124 infants) or the standard T-piece system with face mask (n = 122 infants). The intervention was providing continuous positive airway pressure for 10 to 30 minutes and positive pressure ventilation, if needed, with the randomized system. Main outcomes and measures: The primary outcome was delivery room intubation or death within 30 minutes of birth. Secondary outcomes included respiratory and safety variables. Results: Of 246 liveborn infants treated, the mean (SD) gestational age was 25.9 (1.3) weeks, and 127 (51.6%) were female. A total of 41 infants (33.1%) receiving the new respiratory support system were intubated or died in the delivery room compared with 55 infants (45.1%) receiving standard care. The adjusted odds ratio was statistically significant after adjusting for stratification variables (adjusted odds ratio, 0.53; 95% CI, 0.30-0.94; P = .03). No significant differences were seen in secondary outcomes or safety variables. Conclusions and relevance: In this study, using the new respiratory support system reduced delivery room intubation in extremely preterm infants. Stabilizing preterm infants with a system that has low imposed work of breathing and binasal prongs as interface is safe and feasible.en_US
dc.description.sponsorshipSwedish Heart-Lung Foundation Region Stockholm ALF Freemason Child House Fund Stockholm Sallskapet Barnavard Research Fund Swedish Society of Medicineen_US
dc.language.isoenen_US
dc.publisherAmerican Medical Associationen_US
dc.relation.urlhttps://jamanetwork.com/journals/jamapediatrics/fullarticle/2780513en_US
dc.subjectRespiratory Supporten_US
dc.subjectpreterm infantsen_US
dc.subjectFyrirburaren_US
dc.subjectÖndunarvélaren_US
dc.subject.meshInfant, Prematureen_US
dc.subject.meshContinuous Positive Airway Pressureen_US
dc.titleComparison of Respiratory Support After Delivery in Infants Born Before 28 Weeks' Gestational Age: The CORSAD Randomized Clinical Trial.en_US
dc.typeArticleen_US
dc.identifier.eissn2168-6211
dc.contributor.department1Department of Neonatology, Karolinska University Hospital, Stockholm, Sweden. 2Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden. 3Department of Anesthesiology and ICU, Östersund Hospital, Östersund, Sweden. 4Department of Neonatology, Stavanger University Hospital, Stavanger, Norway. 5Department of Neonatology, Linköping University Hospital, Linköping, Sweden. 6Department of Neonatology, Neonatal Biophysical Monitoring and Cardiopulmonary Therapies Research Unit, Poznan University of Medical Sciences, Poznan, Poland. 7Department of Neonatology, Sahlgrenska University Hospital, Gothenburg, Sweden. 8Department of Neonatology, Vilnius University Hospital, Vilnius, Lithuania. 9Department of Neonatology, The National University Hospital of Iceland, Reykjavík, Iceland. 10Unit of Research, Education and Development, Östersund Hospital, Östersund, Sweden. 11Department of Neonatology, Vilnius Maternity Hospital, Vilnius, Lithuania.en_US
dc.identifier.journalJAMA pediatricsen_US
dc.rights.accessLandspitali Access - LSH-aðganguren_US
dc.departmentcodePED12
dc.source.journaltitleJAMA pediatrics
dc.source.volume175
dc.source.issue9
dc.source.beginpage911
dc.source.endpage918
dc.source.countryUnited States


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