Elsevier

Resuscitation

Volume 84, Issue 11, November 2013, Pages 1558-1561
Resuscitation

Clinical paper
Marked variation in delivery room management in very preterm infants

Under a Creative Commons license
open access

Abstract

Background

The International Liaison Committee on Resuscitation (ILCOR) and UK 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 UK.

Methods

We emailed a national survey of current DR stabilisation practice of very preterm infants to all UK 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.

Abbreviations

NICU
neonatal intensive care unit
DR
delivery room
CPAP
continuous positive airway pressure
PEEP
positive end expiratory pressure
NDAU
neonatal data analysis unit
NPEU
national perinatal epidemiology unit

Keywords

Stabilisation practice in preterm infants
Neonatal resuscitation
Survey
Practice variation
View Abstract