Respiratory Management of Extremely Preterm Infants: An International Survey

Fecha de publicación: 01/01/2018

Autores de IIS La Fe

Máximo Vento Torres

Autor

Participantes ajenos a IIS La Fe

Beltempo, Marc
Isayama, Tetsuya
Lui, Kei
Kusuda, Satoshi
Lehtonen, Liisa
Sjors, Gunnar
Hakansson, Stellan
Adams, Mark
Noguchi, Akihiko
Reichman, Brian
Darlow, Brian A.
Morisaki, Naho
Bassler, Dirk
Pratesi, Simone
Lee, Shoo K.
Lodha, Abhay
Modi, Neena
Helenius, Kjell
Shah, Prakesh S.
Int Network Evaluating Outcomes Ne

Grupos

Perinatología

Leader

Máximo Vento Torres

Abstract

Background: There are significant international variations in chronic lung disease rates among very preterm infants yet there is little data on international variations in respiratory strategies. Objective: To evaluate practice variations in the respiratory management of extremely preterm infants born at <29 weeks' gestational age (GA) among 10 neonatal networks participating in the International Network for Evaluating Outcomes (iNeo) of Neonates collaboration. Methods: A web-based survey was sent to the representatives of 390 neonatal intensive care units from Australia/New Zealand, Canada, Finland, Illinois (USA), Israel, Japan, Spain, Sweden, Switzerland, and Tuscany (Italy). Responses were based on practices in 2015. Results: Overall, 321 of the 390 units responded (82%). The majority of units within networks (40-92%) mechanically ventilate infants born at 23-24 weeks' GA on continuous positive airway pressure (CPAP) with 30-39% oxygen in respiratory distress within 48 h after birth, but the proportion of units that offer mechanical ventilation for infants born at 25-26 weeks' GA at similar settings varied significantly (20-85% of units within networks). The most common respiratory strategy for infants born at 27-28 weeks' GA on CPAP with 30-39% oxygen with respiratory distress within 48 h after birth used by units also varied significantly among networks: mechanical ventilation (0-60%), CPAP (3-82%), intubation and surfactant administration with immediate extubation (0-75%), and less invasive surfactant administration (0-68%). Conclusions: There are marked variations but also similarities in respiratory management of extremely preterm infants between networks. Further collaboration and exploration is needed to better understand the association of these variations in practice with pulmonary outcomes. (c) 2018 S. Karger AG, Basel

Datos de la publicación

ISSN/ISSNe:: 1661-7800, 1661-7819
Tipo:: Article
Páginas:: 28-36
DOI:: 10.1159/000487987
Factor de Impacto:: 1,210 SCImago ℠
Cuartil:: Q1 SCImago ℠

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Métricas

Filiaciones

Beltempo, Marc:: Univ Toronto, Mt Sinai Hosp, Maternal Infant Care Res Ctr, Dept Paediat, Toronto, ON, Canada
Isayama, Tetsuya:: McMaster Univ, Clin Epidemiol & Biostat, Toronto, ON, Canada
Vento, Maximo:: Instituto de Investigación. Hlth Res Inst La Fe, Spanish Neonatal Network, Ave Fernando Abril Martorell, Valencia, Spain
Lui, Kei:: Univ New South Wales, Royal Hosp Women, Natl Perinatal Epidemiol & Statist Unit, Australian & New Zealand Neonatal Network, Randwick, NSW, Australia
Kusuda, Satoshi:: Tokyo Womens Med Univ, Maternal & Perinatal Ctr, Neonatal Res Network Japan, Tokyo, Japan
Lehtonen, Liisa:: Univ Turku, Turku Univ Hosp, Dept Pediat, Turku, Finland
Sjors, Gunnar:: Uppsala Univ, Dept Womens & Childrens Hlth, Swedish Neonatal Qual Register, Uppsala, Sweden
Hakansson, Stellan:: Umea Univ Hosp, Dept Pediat, Swedish Neonatal Qual Register, Neonatal Serv, Umea, Sweden
Adams, Mark:: Univ Zurich, Univ Hosp Zurich, Dept Neonatol, Swiss Neonatal Network, Zurich, Switzerland
Noguchi, Akihiko:: Illinois Neonatal Network, St Louis, IL USA
Reichman, Brian:: Sheba Med Ctr, Gertner Inst Epidemiol & Hlth Policy Res, Israel Neonatal Network, Tel Hashomer, Israel
Darlow, Brian A.:: Univ Otago, Dept Paediat, Australia & New Zealand Neonatal Network, Christchurch, New Zealand
Morisaki, Naho:: Natl Ctr Child Hlth & Dev, Dept Social Med, Neonatal Res Network Japan, Tokyo, Japan
Bassler, Dirk:: Univ Zurich, Univ Hosp Zurich, Dept Neonatol, Swiss Neonatal Network, Zurich, Switzerland
Pratesi, Simone:: Careggi Univ Hosp, Neonatal Intens Care Unit, TIN Toscane Online, Florence, Italy
Lee, Shoo K.:: Univ Toronto, Mt Sinai Hosp, Maternal Infant Care Res Ctr, Dept Paediat, Toronto, ON, Canada
Lodha, Abhay:: Univ Calgary, Pediat & Community Hlth Sci, Calgary, AB, Canada
Modi, Neena:: Imperial Coll London, Dept Med, Neonatal Data Anal Unit, Sect Neonatal Med,UK Neonatal Collaborat, Chelsea & Westminster Hosp Campus, London, England
Helenius, Kjell:: Univ Turku, Turku Univ Hosp, Dept Pediat, Turku, Finland
Shah, Prakesh S.:: Univ Toronto, Mt Sinai Hosp, Maternal Infant Care Res Ctr, Dept Paediat, Toronto, ON, Canada