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Utilizing a nasal masks as a substitute of a standard face masks to help very untimely infants at start can considerably cut back the necessity for rescue respiratory and escalation of care, a world-first trial led by researchers at Monash College’s Faculty of Scientific Sciences at Monash Well being, in collaboration with Hudson Institute of Medical Analysis and Monash Youngsters’s Hospital (Monash Well being), has proven.
Printed right this moment in The Lancet Little one & Adolescent Well being, the FONDUE trial (“Face mask versus nasal mask device use for initial resuscitation in extremely and very premature infants”) enrolled 151 newborns born between 23 and 31 weeks’ gestation at Monash Youngsters’s Hospital.
Practically all infants born greater than two months early require assist respiratory instantly after start. Many of those fragile newborns will take a primary breath or let loose a cry, however then cease respiratory and wish pressing assist from medical doctors and nurses to maintain oxygen flowing to their tiny lungs. This pressing intervention, often called constructive strain air flow or “rescue breathing,” is life-saving however may expose the preterm lung to excessive inflation pressures that trigger harm.
If rescue respiratory with a face masks is unsuccessful, clinicians might need to escalate to putting a respiratory tube into the lungs through an emergency intubation. It’s broadly accepted that supporting a preterm child to proceed to breathe spontaneously and keep away from intubation will result in the perfect long-term consequence.
The FONDUE trial discovered that offering preliminary help by means of a nasal masks meant fewer infants wanted this sort of rescue respiratory. Lead creator Dr. Douglas Clean, researcher in Monash College’s Faculty of Scientific Sciences and Hudson Institute of Medical Analysis, and New child Advisor at Monash Youngsters’s Hospital, mentioned “In our trial, we reduced the need for rescue breathing from 58% to 39% by using a nasal mask to provide initial help breathing instead of the traditional face mask.”
“We believe that this improvement in successfully supporting breathing in extremely and very preterm infants using a nasal mask is due to more newborns continuing to breathe well after birth. The findings have the potential for immediate impact to improve care of fragile preterm newborns because the intervention is simple to implement and readily available.”
Quick scientific implications
The intervention was offered within the supply room through the first 20 minutes of life, earlier than infants had been admitted to the neonatal intensive care unit (NICU). Researchers consider that encouraging and supporting spontaneous respiratory efforts in extraordinarily preterm infants may enhance long-term outcomes.
Senior creator Affiliate Professor Calum Roberts, from the Faculty of Scientific Sciences at Monash Well being, mentioned the outcomes are particularly important for infants born earlier than 28 weeks.
“Initial use of a nasal mask doubled the likelihood of successful breathing support without escalation in extremely preterm babies,” Affiliate Professor Roberts mentioned. “Avoiding high-pressure ventilation and intubation at birth could have lasting benefits for their fragile lungs and brains.”
With greater than 25,000 infants born preterm annually in Australia, the researchers mentioned the findings might quickly change supply room observe.
“Encouraging spontaneous breathing from the first moments of life is a simple, low-cost change that can be adopted worldwide,” Dr. Clean mentioned. “Our hope is that these results improve outcomes for the most vulnerable newborns.”
Extra info:
Douglas A Clean et al, Face masks versus nasal masks machine use for preliminary resuscitation in extraordinarily and really preterm infants (FONDUE): an open-label, single-centre, randomised, managed trial, The Lancet Little one & Adolescent Well being (2025). DOI: 10.1016/S2352-4642(25)00193-2
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Nasal masks help improves inhaling preterm infants in scientific trial (2025, September 3)
retrieved 3 September 2025
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