Feasibility of portable capnometer for mechanically ventilated preterm infants in the delivery room

This study aimed to determine whether a specific portable capnometer (EMMA™) can facilitate the maintenance of an appropriate partial pressure of arterial carbon dioxide (PaCO(2)) in intubated preterm infants in the delivery room. This study included preterm infants with a gestational age of 26 + 0 to 31 + 6 weeks who required intubation in the delivery room. We prospectively identified 40 infants who underwent the EMMA™ monitoring intervention group and 43 infants who did not undergo monitoring (historical control group). PaCO(2) was evaluated either at admission in the neonatal intensive care unit or at 2 h after birth. The proportion of infants with an appropriate PaCO(2) (35–60 mmHg) was greater in the intervention group than in the control group (80% vs. 42%; p = 0.001). There were no significant differences in the rate of accidental extubation (5.0% vs. 7.0%, p = 1.00) or in the proportion of infants with an appropriate PaCO(2) among infants whose birth weight was < 1000 g (54% vs. 40%, p = 0.49). However, among infants whose birth weight was ≥ 1000 g, the PaCO(2) tended to be more appropriate in the intervention group than in the control group (93% vs. 44%; p < 0.001). Conclusion: The EMMA™ facilitated the maintenance of an appropriate PaCO(2) for mechanically ventilated preterm infants, especially infants with birth weight ≥1000 g, in the delivery room. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00431-021-04246-1.