380 Neonatal Resuscitation of Extremely Low Birth Weight Infants: A Survey of Practice in Italy

Abstract

Background/aims: There is a lack of information regarding the delivery room management of the extremely low birth weight infants (ELBWI). We aimed to survey the practice and the approach to the neonatal resuscitation of the ELBWIs in Italian tertiary centres.

Methods: A structured 73-item questionnaire was sent to the heads of the 86 Italian neonatal intensive care units (NICU) provided with on-side delivery.

Results: Information was obtained for 74 (86%) centres, in which 1294 (median 15; range 1–63) ELBWIs were born in year 2002. One hundred oxygen concentration for resuscitation of ELBWIs was used in 41 (55.4%) centres; in the remaining 33 (44.6%), varying oxygen concentrations (median 40%; range 21–70) were provided. The positive pressure ventilation was manually administered at 61 (82.4%) centres; at the remaining 13 (17.6%), PPV was administered by using a ventilator. Positive end expiratory pressure was routinely used at 26 (35.1%) centres and delivered tidal volumes were measured at 5 (6.7%). Forty four centres (59.5%) did not administer routinely surfactant in the delivery setting. During the year 2002, 791 (73.7%) out of 1072 ELBWIs born at the 68 responder centres were intubated at birth. In the same period, 230 (21.6%) and 93 (8.7%) out of 1061 ELBWIs born at the 66 responder centres received chest compressions and medications, respectively.

Conclusions: The practice and the approach to the neonatal resuscitation of the ELBWIs vary consistently, reflecting a paucity of evidence and consequent uncertainty among clinicians. Further prospective studies in this field are needed.

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