ArticleArchives of disease in childhood. Fetal and neonatal edition2018
Laryngeal closure impedes non-invasive ventilation at birth.
Article in Archives of disease in childhood. Fetal and neonatal edition, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04413097 (Delayed Cord Clamping With Oxygen In Extremely Low Gestation Infants), which is not on this map. Cited by 48 papers, 4 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Delayed Cord Clamping With Oxygen In Extremely Low Gestation Infants
Who cites it
48 citing papers in PubMed, 4 syntheses or guidelines pooled it, 109 citations in OpenAlex.
- European Consensus Guidelines on the Management of Respiratory Distress Syndrome: 2025.Neonatology · 2026Guideline
- Tactile stimulation in the delivery room: past, present, future. A systematic review.Pediatric research · 2024Pooled it
- Sustained Inflation vs Standard Resuscitation for Preterm Infants: A Systematic Review and Meta-analysis.JAMA pediatrics · 2020Pooled it
- Improving Newborn Respiratory Outcomes With a Sustained Inflation: A Systematic Narrative Review of Factors Regulating Outcome in Animal and Clinical Studies.Frontiers in pediatrics · 2020Pooled it
- Deferred Cord Clamping With High Oxygen in Extremely Preterm Infants: A Randomized Clinical Trial.JAMA pediatrics · 2025Trial
- Sustained Inflation Versus Intermittent Positive Pressure Ventilation for Preterm Infants at Birth: Respiratory Function and Vital Sign Measurements.The Journal of pediatrics · 2021Trial
- The Effect of Antenatal Paracetamol on Breathing Effort of Premature Infants at Birth: A Feasibility Trial.Children (Basel, Switzerland) · 2026Article
- Practical interpretation of ILCOR and neonatal resuscitation program recommendations for initial oxygen concentration for neonatal resuscitation/stabilization.Journal of perinatology : official journal of the California Perinatal Association · 2026Article
- Effect of sustained inflation on pharmacokinetics and pharmacodynamics of endotracheal and supraglottic airway epinephrine in a neonatal piglet model.Pediatric research · 2026Article
- Optimising CPAP and oxygen levels to support spontaneous breathing in preterm rabbits.Pediatric research · 2026Article
- Hypoxia inhibits breathing and causes the glottis to close in preterm rabbit kittens at birth.Pediatric research · 2026Article
- Circulating prostaglandin EFrontiers in pediatrics · 2025Article
- The effect of histological and subclinical chorioamnionitis and funisitis on breathing effort in premature infants at birth: a retrospective cohort study.European journal of pediatrics · 2024Article
- Oxygen saturation and heart rate in healthy term and late preterm infants with delayed cord clamping.Pediatric research · 2024Review
- Impact of neonatal noninvasive resuscitation strategies on lung mechanics, tracheal pressure, and tidal volume in preterm lambs.American journal of physiology. Lung cellular and molecular physiology · 2024Article
- The effect of vibrotactile stimulation on hypoxia-induced irregular breathing and apnea in preterm rabbits.Pediatric research · 2024Article
- The influence of chorioamnionitis on respiratory drive and spontaneous breathing of premature infants at birth: a narrative review.European journal of pediatrics · 2024Review
- Article
- Introducing a novel respiratory function monitor for neonatal resuscitation training.Resuscitation plus · 2024Article
- Optimizing transition: Providing oxygen during intact cord resuscitation.Seminars in perinatology · 2023Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
13 authors at 6 institutions in 4 countries.
Funding
Abstract
backgroundNon-invasive ventilation is sometimes unable to provide the respiratory needs of very premature infants in the delivery room. While airway obstruction is thought to be the main problem, the site of obstruction is unknown. We investigated whether closure of the larynx and epiglottis is a major site of airway obstruction.
methodsWe used phase contrast X-ray imaging to visualise laryngeal function in spontaneously breathing premature rabbits immediately after birth and at approximately 1 hour after birth. Non-invasive respiratory support was applied via a facemask and images were analysed to determine the percentage of the time the glottis and the epiglottis were open. HYPOTHESIS: Immediately after birth, the larynx is predominantly closed, only opening briefly during a breath, making non-invasive intermittent positive pressure ventilation (iPPV) ineffective, whereas after lung aeration, the larynx is predominantly open allowing non-invasive iPPV to ventilate the lung.
resultsThe larynx and epiglottis were predominantly closed (open 25.5%±1.1% and 17.1%±1.6% of the time, respectively) in pups with unaerated lungs and unstable breathing patterns immediately after birth. In contrast, the larynx and the epiglottis were mostly open (90.5%±1.9% and 72.3%±2.3% of the time, respectively) in pups with aerated lungs and stable breathing patterns irrespective of time after birth.
conclusionLaryngeal closure impedes non-invasive iPPV at birth and may reduce the effectiveness of non-invasive respiratory support in premature infants immediately after birth.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.