Researchers from Children’s Hospital of Philadelphia (CHOP) have received funding support from the Patient-Centered Outcomes Research Institute (PCORI) to explore ways of implementing an enhanced newborn resuscitation approach, a surprisingly frequent need for hundreds of thousands of newborn babies in the US each year.
Approximately 1 in 10 of the 3.8 million babies born in the US annually require resuscitation to breathe immediately after birth. While most babies who receive resuscitation survive in the delivery room, needing breathing support at birth puts babies at risk for brain and lung injury and often causes babies to be separated from their parents at this critical early stage of life.
Facemasks are commonly utilized to provide positive pressure ventilation during newborn resuscitation, but they do not always work. Typically, when facemasks fail, placing a breathing tube via intubation is performed, but this is also a risky and challenging procedure to perform in newborns.
To help solve this issue, researchers are proposing the expanded use of supraglottic airways, a group of airway devices that can be inserted into the pharynx to allow ventilation without relying on intubation. Supraglottic airways have been used in adults for many years, but their use in newborns remains low, despite clinical evidence suggesting this is a safer method for resuscitation.
Elizabeth E. Foglia, MD, MSCE, an attending physician in the Division of Neonatology and principal investigator of the Delivery Room of the Future Frontier Program at CHOP, and Chris Bonafide, MD, MSCE, Associate Chief of the Division of General Pediatrics and Co-Associate Director for Implementation Science of Clinical Futures at CHOP, will co-lead the Supraglottic Airway for Resuscitation (SUGAR) Trial.
This trial will be conducted through the Delivery Room Intervention and Evaluation (DRIVE) Network, which aims to innovate health care delivery by designing and testing solutions to improve provider training, team performance, and clinical outcomes for newborns who require resuscitation at birth. Founded by the American Academy of Pediatrics in 2022, the network now has more than 50 hospitals that have signed agreements or are already sharing data.
The SUGAR trial will compare two implementation strategies to promote supraglottic airway use during newborn resuscitation. In the first strategy, hospitals will receive a package of five implementation tools to promote supraglottic airway use with no additional external support. In the second strategy, the same five tools will be utilized as well as two additional tools that involve external support from outside experts and peer hospitals that have successfully implemented the supraglottic airway.
“We want to ensure healthcare providers are using evidence-based practices to support newborns, particularly at birth when so many critical health decisions need to be made quickly,” Foglia said. “We are grateful to PCORI for recognizing how significant this work is. We are excited to conduct SUGAR throughout the DRIVE netwrk, which makes this research possible in the first place.”
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Researchers from Children’s Hospital of Philadelphia (CHOP) have received funding support from the Patient-Centered Outcomes Research Institute (PCORI) to explore ways of implementing an enhanced newborn resuscitation approach, a surprisingly frequent need for hundreds of thousands of newborn babies in the US each year.
Approximately 1 in 10 of the 3.8 million babies born in the US annually require resuscitation to breathe immediately after birth. While most babies who receive resuscitation survive in the delivery room, needing breathing support at birth puts babies at risk for brain and lung injury and often causes babies to be separated from their parents at this critical early stage of life.
Facemasks are commonly utilized to provide positive pressure ventilation during newborn resuscitation, but they do not always work. Typically, when facemasks fail, placing a breathing tube via intubation is performed, but this is also a risky and challenging procedure to perform in newborns.
To help solve this issue, researchers are proposing the expanded use of supraglottic airways, a group of airway devices that can be inserted into the pharynx to allow ventilation without relying on intubation. Supraglottic airways have been used in adults for many years, but their use in newborns remains low, despite clinical evidence suggesting this is a safer method for resuscitation.
Elizabeth E. Foglia, MD, MSCE, an attending physician in the Division of Neonatology and principal investigator of the Delivery Room of the Future Frontier Program at CHOP, and Chris Bonafide, MD, MSCE, Associate Chief of the Division of General Pediatrics and Co-Associate Director for Implementation Science of Clinical Futures at CHOP, will co-lead the Supraglottic Airway for Resuscitation (SUGAR) Trial.
This trial will be conducted through the Delivery Room Intervention and Evaluation (DRIVE) Network, which aims to innovate health care delivery by designing and testing solutions to improve provider training, team performance, and clinical outcomes for newborns who require resuscitation at birth. Founded by the American Academy of Pediatrics in 2022, the network now has more than 50 hospitals that have signed agreements or are already sharing data.
The SUGAR trial will compare two implementation strategies to promote supraglottic airway use during newborn resuscitation. In the first strategy, hospitals will receive a package of five implementation tools to promote supraglottic airway use with no additional external support. In the second strategy, the same five tools will be utilized as well as two additional tools that involve external support from outside experts and peer hospitals that have successfully implemented the supraglottic airway.
“We want to ensure healthcare providers are using evidence-based practices to support newborns, particularly at birth when so many critical health decisions need to be made quickly,” Foglia said. “We are grateful to PCORI for recognizing how significant this work is. We are excited to conduct SUGAR throughout the DRIVE netwrk, which makes this research possible in the first place.”
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Amanda DiPaolo Bradley
Division of Neonatology