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Neonatal Postresuscitation Care in Brazil: A National Overview
João César Lyra1, Ligia Maria Suppo de Souza Rugolo1, Leni Márcia Anchieta2
1Department of Pediatrics, UNESP, Univiversidade Estadual Paulista, Sao Paulo State, Brazil.
Insights
Post-resuscitation care (PRC) in Brazil lacks standardization among instructors. Enhanced training and consistent protocols are crucial for improving newborn outcomes.
Area of Science:
- Neonatology
- Pediatrics
- Clinical Interventions
Background:
- Post-resuscitation care (PRC) involves systematic interventions for stabilizing at-risk newborns.
- Effective PRC is vital for improving neonatal clinical outcomes.
Purpose of the Study:
- To evaluate current post-resuscitation care practices among instructors in the Brazilian Neonatal Resuscitation Program (BNRP).
- Assessing the implementation and standardization of PRC protocols in Brazil.
Main Methods:
- A cross-sectional, descriptive online survey was conducted among BNRP instructors.
- Data collected on professional background, work setting, and specific PRC practices using a 55-item questionnaire.
- Descriptive statistics were used to analyze findings from 740 respondents.
Main Results:
- Only 41% of respondents received targeted PRC training, with 56% having only theoretical instruction.
- A significant portion (37%) believed PRC was only for newborns needing advanced interventions.
- Less than half (49%) reported written PRC protocols, with considerable variation in content and implementation.
Conclusions:
- Post-resuscitation care practices in Brazil are inconsistent and not systematically implemented.
- There is a critical need for standardized PRC protocols and comprehensive training for pediatricians involved in neonatal care.
- Improving PRC standardization is essential for better neonatal outcomes in Brazil.
Objectives:
Postresuscitation care (PRC) encompasses structured and systematic interventions aimed at promptly stabilizing at-risk newborns in order to improve clinical outcomes. This study aimed to assess PRC practices as reported by pediatricians who serve as instructors in the Brazilian Neonatal Resuscitation Program (BNRP) of the Brazilian Pediatric Society.
Methods:
We conducted a cross-sectional, descriptive survey among BNRP instructors. Data were collected via a 55-item online questionnaire (Google Forms), covering respondents' professional background, primary work setting, and specific PRC practices. A convenience sample was used, and descriptive statistics summarized the findings.
Results:
A total of 740 responses were obtained, representing 63% of BNRP instructors. Of these, 79% were neonatologists, 88% with over 10 years of professional experience. Most worked in public (61%) and teaching hospitals (76%). Only 41% had received targeted PRC training; of these, 56% had exclusively theoretical instruction. Regarding the scope of PRC, 37% believed interventions were indicated solely for newborns requiring intubation, chest compression, or medications in the delivery room. Overall, 49% of respondents reported having written PRC protocols at their institutions, though their content and implementation varied considerably.
Conclusion:
PRC practices in Brazil are neither homogeneous nor systematically implemented across most neonatology services involving BNRP instructors. These findings highlight the pressing need for enhanced dissemination of standardized PRC protocols and comprehensive training for pediatricians engaged in neonatal care.
Key Points:
· PRC can improve outcomes in high-risk newborns, but its real-world application remains poorly described in middle-income countries.. · This is the largest study to date on PRC practices, based on responses from instructors of the Brazilian Neonatal Resuscitation Program.. · Findings reveal the need for structured training and underscore the importance of further research on the impact of standardized PRC on neonatal outcomes..
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