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Survey on Delivery Room Ventilation of Preterm and Term Infants in German-Speaking Countries
Julian C Brozek1, Christian Maiwald1, Paul-Philip Warth1
1Department of Neonatology, Tübingen University Hospital, Tübingen, Germany.
Aim:
We investigated current practices of primary ventilation of preterm and term infants directly after birth in hospitals across all levels of neonatal care in Germany, Austria and Switzerland.
Methods:
Invitations to an electronic survey were sent to all hospitals with maternity wards in these three countries. Results were compared across countries and gestational age (GA) groups.
Results:
240 out of 769 (31%) contacted hospitals participated. Most hospitals used T-piece resuscitators for term infants (85%). Use of mechanical ventilators increased with decreasing GA (term: 7%, moderate-to-late preterm (MLP, GA 32-36 weeks): 11%, very preterm (GA < 32 weeks): 23%). In very preterm infants, extended inspiratory times of 1-5 s were the preferred method of initial ventilation (56%), followed by inspiratory times < 1 s (36%). Initial positive end-expiratory pressure (PEEP) increased with decreasing GA; median (interquartile range, IQR) PEEP for term infants 5.0 cmH2O (5.0-6.0 cmH2O), for MLP 6.0 cmH2O (5.0-6.0 cmH2O), and for very preterm infants 6.0 cmH2O (5.0-8.0 cmH2O). Laryngeal masks were used in 14% of centres as the preferred alternative airway for term infants.
Conclusion:
We found considerable differences across and within participating countries and GA groups in the primary respiratory support during delivery room stabilization of newborn infants.
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