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Resuscitation. 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.

Author information

1
Department of Neonatology, The Rosie Hospital, Cambridge University Hospitals NHS Foundation Trust, United Kingdom; Bradford Neonatology, Bradford Teaching Hospitals NHS Trust, United Kingdom. Electronic address: Yogen.Singh@nhs.net.

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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