Oxygen supplementation in the delivery room: T-piece resuscitator cap open or occluded?

Objectiveupdated neonatal resuscitation guidelines for free-flow oxygen administration with a t-piece resuscitator recommend higher gas flow and an open t-piece cap. we aimed to determine the effect of gas inflow rate and cap occlusion on oxygen delivery through a t-piece resuscitator.study designusing a neopuff™ t-piece, oxygen inflow was randomly adjusted from 4 to 10 liters per minute (lpm). gas outflow and oxygen concentration were measured with the t-piece cap open and occluded. data were analyzed with repeated measures 2-way anova.resultgas outflow was significantly decreased with the t-piece cap open compared with occluded at each inflow rate (p < 0.001). there was no difference in oxygen concentration of the outflow gas.conclusiongas flow from the t-piece is affected by the inflow rate and cap occlusion but oxygen concentration is not. to deliver 5 lpm of free-flow oxygen with the cap open, a minimum of 8 lpm gas inflow is required.