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Respiratory Management of Extremely Preterm Infants: An International Survey

Marc Beltempo1, Tetsuya Isayama2, Máximo Vento3

  • 1Department of Paediatrics, Mount Sinai Hospital, University of Toronto, Maternal-Infant Care Research Centre, Mount Sinai Hospital, Toronto, Ontario, Canada.

Neonatology
|April 16, 2018
PubMed

Insights

International variations exist in respiratory strategies for extremely preterm infants. This study highlights significant differences in mechanical ventilation and surfactant administration practices across neonatal networks, necessitating further research into pulmonary outcomes.

Area of Science:

  • Neonatology
  • Pediatric Pulmonology
  • Critical Care Medicine

Background:

  • Significant international variations in chronic lung disease rates among very preterm infants are known.
  • However, limited data exists on international variations in respiratory strategies for these vulnerable infants.

Purpose of the Study:

  • To evaluate practice variations in respiratory management for extremely preterm infants (< 29 weeks' gestational age).
  • To compare strategies among 10 international neonatal networks in the International Network for Evaluating Outcomes (iNeo) of Neonates collaboration.

Main Methods:

  • A web-based survey was distributed to 390 neonatal intensive care units across 10 international networks.
  • Responses reflected practices in 2015, with 321 units (82%) providing data.

Main Results:

  • Most units mechanically ventilate infants born at 23-24 weeks' gestational age with continuous positive airway pressure (CPAP) and oxygen.
  • Significant variations were observed in mechanical ventilation use for 25-26 weeks' gestational age infants.
  • Respiratory strategies for 27-28 weeks' gestational age infants, including CPAP, mechanical ventilation, and surfactant administration, varied widely among networks.

Conclusions:

  • Marked variations and some similarities exist in the respiratory management of extremely preterm infants across different neonatal networks.
  • Further collaboration is essential to understand the impact of these practice variations on pulmonary outcomes.
Abstract

Keywords:
Bronchopulmonary dysplasiaPractice variationPreterm infantsVentilation

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