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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.

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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:



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


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


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.


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).


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.


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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