A review of international clinical practice guidelines for the use of oxygen in the delivery room resuscitation of preterm infants

Fecha de publicación: 01/01/2018

Autores de IIS La Fe

Máximo Vento Torres

Autor

Participantes ajenos a IIS La Fe

Wilson A
Shah PS
Saugstad O
Finer N
Rich W
Morton RL
Rabi Y
Tarnow-Mordi W
Suzuki K
Wright IM
Oei JL

Grupos

Perinatología

Leader

Máximo Vento Torres

Abstract

AimTo collate and assess international clinical practice guidelines (CPG) to determine current recommendations guiding oxygen management for respiratory stabilisation of preterm infants at delivery. MethodsA search of public databases using the terms clinical practice guidelines', preterm', oxygen' and resuscitation' was made and complemented by direct query to consensus groups, resuscitation expert committees and clinicians. Data were extracted to include the three criteria for assessment: country of origin, gestation and initial FiO(2) and target SpO(2) for the first 10 minutes of life. ResultsA total of 45 CPGs were identified: 36 provided gestation specific recommendations (<28 to <37 weeks) while eight distinguished only between preterm' and term'. The most frequently recommended initial FiO(2) were between 0.21 and 0.3 (n = 17). Most countries suggested altering FiO(2) to meet SpO(2) targets recommended by expert committees, However, specific five-minute SpO(2) targets differed by up to 20% (70-90%) between guidelines. Five countries did not specify SpO(2) targets. ConclusionCPG recommendations for delivery room oxygen management of preterm infants vary greatly, particularly in regard to gestational ages, initial FiO(2) and SpO(2) targets and most acknowledge the lack of evidence behind these recommendations. Sufficiently large and well-designed randomised studies are needed to inform on this important practice.

Datos de la publicación

ISSN/ISSNe:: 0803-5253, 1651-2227
Tipo:: Review
Páginas:: 20-27
DOI:: 10.1111/apa.14012
Factor de Impacto:: 1,031 SCImago ℠
Cuartil:: Q1 SCImago ℠

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Métricas

Filiaciones

Wilson A:: Department of Newborn Care, The Royal Hospital for Women, Randwick, NSW, Australia
Vento M:: Division of Neonatology, University and Polytechnic Hospital La Fe, Valencia, Spain
Shah PS:: Department of Pediatrics, Mount Sinai Hospital and University of Toronto, Toronto, ON, Canada
Saugstad O:: Department of Pediatric Research, The University of Oslo, Oslo University Hospital, Oslo, Norway
Finer N:: University of California, San Diego, CA, USA
Rich W:: University of California, San Diego, CA, USA
Morton RL:: NHMRC Clinical Trials Centre, University of Sydney, Camperdown, NSW, Australia
Rabi Y:: University of Calgary, Calgary, AB, Canada

Alberta Children's Hospital Research Institute, Calgary, AB, Canada
Tarnow-Mordi W:: NHMRC Clinical Trials Centre, University of Sydney, Camperdown, NSW, Australia
Suzuki K:: Department of Pediatrics, Tokai University School of Medicine, Isehara, Kanagawa, Japan
Wright IM:: Illawarra Health and Medical Research Institute and Graduate Medicine, The University of Wollongong, Wollongong, NSW, Australia
Oei JL:: Department of Newborn Care, The Royal Hospital for Women, Randwick, NSW, Australia

NHMRC Clinical Trials Centre, University of Sydney, Camperdown, NSW, Australia

School of Women's and Children's Health, the University of New South Wales, Kensington, NSW, Australia