Donaldsson S, Drevhammar T, Li Y, et al. - In this randomized clinical trial, researchers ascertained if using a new respiratory support system with low imposed work of breathing and short binasal prongs decreases delivery room intubations or death compared with a standard T-piece system with a face mask. In total, 365 mothers were recruited, and 250 infants were randomized before birth and 246 liveborn infants were treated. Infants were randomly assigned to either the new respiratory support system with short binasal prongs (n = 124 infants) or the standard T-piece system with face mask (n = 122 infants). With the randomized system, the intervention was to provide continuous positive airway pressure for 10 to 30 minutes and positive pressure ventilation if needed. In total, 41 infants (33.1%) getting the new respiratory support system were intubated or died in the delivery room compared with 55 infants (45.1%) receiving standard care. The use of the new respiratory support system reduced delivery room intubation in extremely preterm infants in this study. It is safe and feasible to stabilize preterm infants using a system with low imposed work of breathing and binasal prongs as an interface.