Monitoring Neonatal Resuscitation Trial

To test the hypothesis that observing the data and waveforms displayed on an RFM during the provision of PPV to preterm infants (24-27 6/7 weeks gestation) after birth will increase the percentage of inflations performed with a predefined VTe "safe range" of 4 - 8 mls/kg.

Median percentage of oxygen saturation (SpO2) captured on the Respiratory Function Monitor in the first 5 minutes of life

Median Heart rate captured on the Respiratory Function Monitor between 3 and10 minutes of life

Percentage of time with significant mask leak (defined as > 60%) during the duration of PPV ventilation per infant in the first 15 minutes of resuscitation.

Percentage of PPV inflations with airway obstruction in the first 15 minutes of resuscitation. Airway obstruction is defined as Vte <1 mL/kg, with minimal mask leak (<25%) during an inflation and flattening of the flow waves.

Percentage of PPV inflations with inadequate tidal volume defined as Vte <4 ml/kg in the first 15 minutes of resuscitation.

Median percentage of Oxygen saturation (SpO2) captured on the Respiratory Function Monitor between 3 and 10 minutes of life

Median fraction of inspired oxygen (FiO2) provided to the infant between 3 and 10 minutes of life

Total duration of time where FiO2 of 100% is delivered to the patient in first 10 minutes of life will be calculated taking into consideration birth weight, tidal volume, respiratory rate, FiO2 and timing of stabilization.

Number of Participants receiving Endotracheal Intubation in the delivery room from time of birth to admission to NICU

Number of participants requiring inotropes for circulatory support in the Neonatal Intensive Care Unit in the first 3 days after birth

Number of participants with pneumothorax in the first 72 hours after birth reported by a radiologist masked to the intervention

Number of participants with Pulmonary Interstitial Emphysema in the first 72 hours after birth reported by a radiologist masked to the intervention

Number of participants with abnormal cranial ultrasound findings (i) all intraventricular hemorrhage, (ii) severe - ie. Papile grade III and IV intraventricular hemorrhage, (iii) cystic periventricular leukomalacia through study completion, an average of 4 months

Duration of endotracheal (ET) ventilation days through study completion, an average of 4 months

Duration of non-invasive ventilation, days through study completion, an average of 4 months

Duration of supplemental oxygen therapy days through study completion, an average of 4 months

Total duration of assisted ventilation (ET, CPAP) in hours through study completion, an average of 4 months

Number of participants with a diagnosis of bronchopulmonary dysplasia (BPD) at 36 weeks corrected gestational age defined as the need for supplementary oxygen and/or any form respiratory support

Neonatal mortality from the time of birth until hospital discharge or 44 weeks corrected gestational age, whichever occurred first

Composite outcome of death or BPD. BPD assessed at corrected gestational age of 36 weeks; death assessed from time of birth until discharge, up to 44 weeks corrected gestational age

Number of participants with Retinopathy of prematurity requiring treatment before hospital discharge, an average of 4 months

Number of participants with a diagnosis of Necrotizing enterocolitis grade 2 or more before hospital discharge, an average of 4 months

Number of participants requiring fluid boluses for circulatory support in the Neonatal Intensive Care Unit within the first 3 days of life

Number of Participants with Endotracheal Intubation in the NICU in the first 24 hours of life

Neonatal Mortality in the delivery room from time of birth until transfer to NICU