Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Nov;114(11):2961-2968.
doi: 10.1111/apa.70198. Epub 2025 Jun 21.

Survey Shows Limited Adoption of the Avoidance of Mechanical Ventilation in Japan: A Cross-Sectional Study

Takashi Shima  1 , Takeshi Kusuda  1 , Nobuhiko Kan  1 , Tadamune Kinjo  1 , Mallinath Chakraborty  2 , Ian Paul Morris  2
Affiliations

Survey Shows Limited Adoption of the Avoidance of Mechanical Ventilation in Japan: A Cross-Sectional Study

Takashi Shima et al. Acta Paediatr. 2025 Nov.

Abstract

Aim: To investigate Japanese perspectives on the avoidance of mechanical ventilation strategy for extremely preterm infants.

Methods: A web-based questionnaire was sent to the perinatal centres enrolled in the Japanese Neonatologist Association and the Japanese Society of Perinatal and Neonatal Circulatory Management. The enrollment window was between the 21st of July and the 31st of December 2021.

Results: This survey covered 59% of the general perinatal centres in Japan. The study revealed that 64% of respondents would not attempt early continuous positive airway pressure strategy for extremely preterm infants. Intubation-surfactant-extubation and less-invasive surfactant administration were used in 58% and 11% of the institutes, respectively. Technical unfamiliarity, insufficient evidence, lack of videolaryngoscopy and concerns about potential complications hindered the implementation of less-invasive surfactant administration.

Conclusions: Early continuous positive airway pressure strategy was uncommon for extremely preterm infants. Intubation-surfactant-extubation was five times more popular than less-invasive surfactant administration. Lack of training, evidence, videolaryngoscopy and assurance were the key limiting factors for the uptake of less-invasive surfactant administration across Japan.

Keywords: Japan; neonatology; noninvasive ventilation; respiratory distress syndrome; surveys and questionnaires.

PubMed Disclaimer

References

    1. W. H. Northway, Jr., R. C. Rosan, and D. Y. Porter, “Pulmonary Disease Following Respirator Therapy of Hyaline‐Membrane Disease. Bronchopulmonary Dysplasia,” New England Journal of Medicine 276, no. 7 (1967): 357–368.
    1. K. Tanaka, R. Hayashi, Y. Ariyama, N. Takahashi, and F. Namba, “Management of Bronchopulmonary Dysplasia in Japan: A Nationwide Survey,” Early Human Development 186 (2023): 105867.
    1. M. Beltempo, T. Isayama, M. Vento, et al., “Respiratory Management of Extremely Preterm Infants: An International Survey,” Neonatology 114, no. 1 (2018): 28–36.
    1. B. J. Stoll, N. I. Hansen, E. F. Bell, et al., “Neonatal Outcomes of Extremely Preterm Infants From the NICHD Neonatal Research Network,” Pediatrics 126, no. 3 (2010): 443–456.
    1. D. G. Sweet, V. P. Carnielli, G. Greisen, et al., “European Consensus Guidelines on the Management of Respiratory Distress Syndrome: 2022 Update,” Neonatology 120, no. 1 (2023): 3–23.

MeSH terms

Substances

LinkOut - more resources