Oxygenation with T-piece versus self-inflating bag for ventilation of extremely preterm infants at birth: a randomized controlled trial

J Pediatr. 2011 Jun;158(6):912-918.e1-2. doi: 10.1016/j.jpeds.2010.12.003. Epub 2011 Jan 15.


Objective: To investigate whether infants < 29 weeks gestation who receive positive pressure ventilation (PPV) immediately after birth with a T-piece have higher oxygen saturation (SpO₂) measurements at 5 minutes than infants ventilated with a self inflating bag (SIB).

Study design: Randomized, controlled trial of T-piece or SIB ventilation in which SpO₂ was recorded immediately after birth from the right hand/wrist with a Masimo Radical pulse oximeter, set at 2-second averaging and maximum sensitivity. All resuscitations started with air.

Results: Forty-one infants received PPV with a T-piece and 39 infants received PPV with a SIB. At 5 minutes after birth, there was no significant difference between the median (interquartile range) SpO₂ in the T-piece and SIB groups (61% [13% to 72%] versus 55% [42% to 67%]; P = .27). More infants in the T-piece group received oxygen during delivery room resuscitation (41 [100%] versus 35 [90%], P = .04). There was no difference in the groups in the use of continuous positive airway pressure, endotracheal intubation, or administration of surfactant in the delivery room.

Conclusion: There was no significant difference in SpO₂ at 5 minutes after birth in infants < 29 weeks gestation given PPV with a T-piece or a SIB as used in this study.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Equipment Design
  • Female
  • Gestational Age
  • Humans
  • Infant, Newborn
  • Infant, Premature
  • Insufflation / instrumentation
  • Intubation, Intratracheal / instrumentation
  • Male
  • Neonatology
  • Oximetry / methods
  • Oxygen / chemistry*
  • Positive-Pressure Respiration / instrumentation*
  • Positive-Pressure Respiration / methods
  • Respiratory Distress Syndrome, Newborn / therapy*
  • Surface-Active Agents / therapeutic use


  • Surface-Active Agents
  • Oxygen