{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T11:48:52Z","timestamp":1784288932076,"version":"3.55.0"},"reference-count":48,"publisher":"American Academy of Pediatrics (AAP)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,2,1]]},"abstract":"<jats:sec>\n                  <jats:title>BACKGROUND AND OBJECTIVES:<\/jats:title>\n                  <jats:p>Avoidance of delivery room intubation (DRI) reduces death or bronchopulmonary dysplasia (BPD) in preterm neonates. Our objective with this quality improvement project was to decrease DRI rates by improving face mask positive pressure ventilation (Fm-PPV) among infants born \u226429 weeks\u2019 gestation.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS:<\/jats:title>\n                  <jats:p>Key drivers of change were identified from a retrospective review of resuscitation records. A resuscitation bundle to optimize Fm-PPV including the use of a small round mask and end-tidal CO2 detectors, increasing peak inspiratory pressure when indicated, and debriefing after each intubation were implemented in consecutive plan-do-study-act cycles. The DRI rate was tracked by using a control chart. Resuscitation practice and outcomes of pre\u2013quality improvement cohort (QIC) (January 2014\u2013September 2015) were compared with post-QIC (October 2015\u2013December 2016).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS:<\/jats:title>\n                  <jats:p>Of the 314 infants who were resuscitated, 180 belonged to the pre-QIC and 134 to the post-QIC. The antenatal steroid administration rate was higher in the post-QIC (54% vs 88%). More infants in the post-QIC had resolution of bradycardia after Fm-PPV (56% vs 77%, P = .02). Infants in the post-QIC had lower DRI rates (58% vs 37%, P &amp;lt; .01), lower need for mechanical ventilation (85% vs 70%, P &amp;lt; .01), lower rates of BPD (26% vs 13%, P &amp;lt; .01), and severe retinopathy of prematurity (14% vs 5%, P = .01). Rates of DRI, BPD, and severe retinopathy of prematurity remained lower even after controlling for the potential confounders.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS:<\/jats:title>\n                  <jats:p>Implementation of a resuscitation bundle decreased the DRI rate and improved outcomes of preterm infants.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1542\/peds.2018-0201","type":"journal-article","created":{"date-parts":[[2019,1,2]],"date-time":"2019-01-02T18:55:25Z","timestamp":1546455325000},"source":"Crossref","is-referenced-by-count":49,"title":["Quality Improvement Project to Decrease Delivery Room Intubations in Preterm Infants"],"prefix":"10.1542","volume":"143","author":[{"given":"Venkatakrishna","family":"Kakkilaya","sequence":"first","affiliation":[{"name":"University of Texas Southwestern Medical Center, Dallas, Texas; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ihab","family":"Jubran","sequence":"additional","affiliation":[{"name":"University of Texas Southwestern Medical Center, Dallas, Texas; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vaishali","family":"Mashruwala","sequence":"additional","affiliation":[{"name":"University of Texas Southwestern Medical Center, Dallas, Texas; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emma","family":"Ramon","sequence":"additional","affiliation":[{"name":"Parkland Hospital and Health Systems, Dallas, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valerie N.","family":"Simcik","sequence":"additional","affiliation":[{"name":"Parkland Hospital and Health Systems, Dallas, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marjory","family":"Marshall","sequence":"additional","affiliation":[{"name":"Parkland Hospital and Health Systems, Dallas, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L. 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