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. 2013 Nov;84(11):1558-61.
doi: 10.1016/j.resuscitation.2013.06.026. Epub 2013 Aug 12.

Marked variation in delivery room management in very preterm infants

Yoginder Singh  1 , Sam Oddie
Affiliations

Marked variation in delivery room management in very preterm infants

Yoginder Singh et al. Resuscitation. 2013 Nov.

Abstract

Background: The International Liaison Committee on Resuscitation (ILCOR) and U.K. Resuscitation Council (UKRC) updated guidance on newborn resuscitation in late 2010.

Objectives: To describe delivery room (DR) practice in stabilisation following very preterm birth (<32 weeks gestation) in the U.K.

Methods: We emailed a national survey of current DR stabilisation practice of very preterm infants to all U.K. delivery units and conducted telephone follow-up calls.

Results: We obtained 197 responses from 199 units (99%) and complete data from 186 units. Tertiary units administered surfactant in the DR (93% vs. 78%, P=0.01), instituted DR CPAP (77% vs. 50%, P=0.0007), provided PEEP in the delivery room (91% vs. 69%, P=0.0008), and started resuscitation in air or blended oxygen (91% vs. 78%, P=0.04) more often than non-tertiary units. Routine out of hours consultant attendance at very preterm birth was more common in tertiary units (82% vs. 55%, P=0.0005).

Conclusions: Marked variation in DR stabilisation practice of very preterm infants persisted one year after the publication of revised UKRC guidance. Delivery room care provided in non-tertiary units was less consistent with current international guidance.

Keywords: CPAP; DR; NDAU; NICU; NPEU; Neonatal resuscitation; PEEP; Practice variation; Stabilisation practice in preterm infants; Survey; continuous positive airway pressure; delivery room; national perinatal epidemiology unit; neonatal data analysis unit; neonatal intensive care unit; positive end expiratory pressure.

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Figures

Fig. 1
Fig. 1
Mode of CPAP or PEEP provision during DR stabilisation among tertiary and nontertiary neonatal services UK 2011–2012.
Fig. 2
Fig. 2
Proportion of neonatal services using air, oxygen or blended oxygen for DR stabilisation following very preterm birth.
See this image and copyright information in PMC

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