The Assisted Breathing before Cord Clamping (ABC) Study Protocol

Major physiologic changes occur during the transition after birth. For preterm infants, current understanding favours allowing the initial changes to occur prior to cord clamping. Amongst other improved outcomes, systematic reviews have indicated a significant reduction in neonatal blood transfusion...

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Main Authors: Michael P. Meyer, Elizabeth Nevill
Format: Article
Language:English
Published: MDPI AG 2021-04-01
Series:Children
Subjects:
Online Access:https://www.mdpi.com/2227-9067/8/5/336
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author Michael P. Meyer
Elizabeth Nevill
author_facet Michael P. Meyer
Elizabeth Nevill
author_sort Michael P. Meyer
collection DOAJ
description Major physiologic changes occur during the transition after birth. For preterm infants, current understanding favours allowing the initial changes to occur prior to cord clamping. Amongst other improved outcomes, systematic reviews have indicated a significant reduction in neonatal blood transfusions following delayed cord clamping. This may be due to a placental transfusion, facilitated by the onset of respiration. If breathing is compromised, placental transfusion may be reduced, resulting in a greater red cell transfusion rate. We designed a randomised trial to investigate whether assisting respiration in this high-risk group of babies would decrease blood transfusion and improve outcomes. The Assisted Breathing before Cord Clamping (ABC) study is a single-centre randomised controlled trial. Preterm infants < 31 weeks that have not established regular breathing before 15 s are randomised to a standard or intervention group. The intervention is intermittent positive pressure ventilation via T piece for 30 s, whilst standard management consists of 30 s of positioning and gentle stimulation. The cord is clamped at 50 s in both groups. The primary outcome is the proportion of infants in each group receiving blood transfusion during the neonatal admission. Secondary outcomes include requirement for resuscitation, the assessment of circulatory status and neonatal outcomes.
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spelling doaj.art-4a13873bd367421d88f4573d5d04f5cb2023-11-21T17:10:10ZengMDPI AGChildren2227-90672021-04-018533610.3390/children8050336The Assisted Breathing before Cord Clamping (ABC) Study ProtocolMichael P. Meyer0Elizabeth Nevill1Neonatal Unit, KidzFirst, Middlemore Hospital, Auckland 2025, New ZealandNeonatal Unit, KidzFirst, Middlemore Hospital, Auckland 2025, New ZealandMajor physiologic changes occur during the transition after birth. For preterm infants, current understanding favours allowing the initial changes to occur prior to cord clamping. Amongst other improved outcomes, systematic reviews have indicated a significant reduction in neonatal blood transfusions following delayed cord clamping. This may be due to a placental transfusion, facilitated by the onset of respiration. If breathing is compromised, placental transfusion may be reduced, resulting in a greater red cell transfusion rate. We designed a randomised trial to investigate whether assisting respiration in this high-risk group of babies would decrease blood transfusion and improve outcomes. The Assisted Breathing before Cord Clamping (ABC) study is a single-centre randomised controlled trial. Preterm infants < 31 weeks that have not established regular breathing before 15 s are randomised to a standard or intervention group. The intervention is intermittent positive pressure ventilation via T piece for 30 s, whilst standard management consists of 30 s of positioning and gentle stimulation. The cord is clamped at 50 s in both groups. The primary outcome is the proportion of infants in each group receiving blood transfusion during the neonatal admission. Secondary outcomes include requirement for resuscitation, the assessment of circulatory status and neonatal outcomes.https://www.mdpi.com/2227-9067/8/5/336pretermdelayed cord clampingresuscitationclinical trialprotocolred blood cell transfusion
spellingShingle Michael P. Meyer
Elizabeth Nevill
The Assisted Breathing before Cord Clamping (ABC) Study Protocol
Children
preterm
delayed cord clamping
resuscitation
clinical trial
protocol
red blood cell transfusion
title The Assisted Breathing before Cord Clamping (ABC) Study Protocol
title_full The Assisted Breathing before Cord Clamping (ABC) Study Protocol
title_fullStr The Assisted Breathing before Cord Clamping (ABC) Study Protocol
title_full_unstemmed The Assisted Breathing before Cord Clamping (ABC) Study Protocol
title_short The Assisted Breathing before Cord Clamping (ABC) Study Protocol
title_sort assisted breathing before cord clamping abc study protocol
topic preterm
delayed cord clamping
resuscitation
clinical trial
protocol
red blood cell transfusion
url https://www.mdpi.com/2227-9067/8/5/336
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