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Status of and problems concerning neonatal resuscitation in Japan in 2015
Tetsuya Kunikata1,2, Kayo Morita1, Hayato Sakurai1
1Division of Neonatal Medicine, Department of Pediatrics, Saitama Medical University Hospital, Iruma, Japan.
Insights
Japanese neonatal resuscitation programs saw improvements, but equipment and techniques remain variable across facilities. Further efforts are needed to ensure widespread availability of essential neonatal resuscitation devices and standardized practices.
Area of Science:
- Neonatal Resuscitation
- Perinatal Care
- Medical Device Distribution
Background:
- The International Liaison Committee on Resuscitation (ILCOR) released Consensus 2015 guidelines, prompting revisions in Japanese neonatal cardiopulmonary resuscitation (CPR) programs.
- A pre-revision survey in January 2015 assessed neonatal resuscitation practices across various Japanese medical facilities.
Purpose of the Study:
- To evaluate the status of neonatal resuscitation systems, equipment, and practices in Japan prior to the 2015 guideline revisions.
- To compare current practices with historical data from 2005, 2010, and 2013.
Main Methods:
- A nationwide questionnaire survey was conducted in January 2015, targeting 277 training hospitals, 459 obstetric hospitals/clinics, and 453 midwife clinics.
- Response rates were 70.8% for training hospitals, 63.6% for obstetric facilities, and 60.9% for midwife clinics.
- Survey data covered neonatal resuscitation systems, medical equipment, practices, and educational frameworks.
Main Results:
- While overall improvements were noted compared to previous surveys, significant variability in equipment availability and usage was observed.
- In training hospitals, oxygen blenders, manometers, and continuous positive airway pressure (CPAP) systems were not universally utilized; expert attendance at deliveries and therapeutic hypothermia facilities were also limited.
- Obstetric facilities and midwife clinics showed deficiencies in essential equipment such as pulse oximeters, manometers, warming equipment, and ventilation bags (masks).
Conclusions:
- Japanese delivery room equipment and preparedness for neonatal resuscitation are inconsistent.
- There is a critical need to improve the distribution of essential neonatal resuscitation devices and enhance the dissemination of standardized resuscitation techniques across all healthcare settings.
Background:
The International Liaison Committee on Resuscitation (ILCOR) published Consensus 2015 in October 2015. Thereafter, the Japanese version of neonatal cardiopulmonary resuscitation programs was revised. Prior to the revision, we re-conducted questionnaire surveys in three types of medical facilities in January 2015.
Methods:
Targeted groups included (i) 277 training hospitals authorized by the Japanese Society of Perinatal/Neonatal Medicine for training of physicians specialized in perinatal care (neonatology) in January 2015 (training hospitals; response rate, 70.8%); (ii) 459 obstetric hospitals/clinics (response rate, 63.6%); and (iii) 453 midwife clinics (response rate, 60.9%). The survey included systems of neonatal resuscitation, medical equipment and practices, and education systems. The results were compared with that of similar surveys conducted in 2005, 2010 and 2013.
Results:
Almost all results were generally improved compared with past surveys. In training hospitals, however, the use of oxygen blenders or manometers was not widespread. Only 35% of institutions used continuous positive airway pressure systems frequently, and expert neonatal resuscitation doctors attended all deliveries in only 6% of training centers. In addition, only 71% of training hospitals had brain therapeutic hypothermia facilities. Not all obstetric hospitals/clinics prepared pulse oximeters, and only a few used manometers frequently. Some midwife clinics did not keep warming equipment, and few midwife clinics were equipped with pulse oximeters. In addition, some midwife clinics did not prepare ventilation bags (masks).
Conclusions:
The equipment in Japanese delivery rooms is variable. Further efforts need to be made in the distribution of neonatal resuscitation devices and the dissemination of techniques.
