Ventilation devices for neonatal resuscitation at birth: A systematic review and meta-analysis

Tribolet, Sophie; Hennuy, Nadège; Rigo, Vincent

doi:10.1016/j.resuscitation.2022.109681

Cited by 5 publications

(2 citation statements)

References 42 publications

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“…Sixty-nine percent of them were academic hospitals. The median (25-75th centile) number of intensive care beds/units of the responding centers was 12 (8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20). Only 32% of the NICUs declared an optimal patient/nurse ratio, i.e., ranging from 1:1 to 2:1.…”

Section: Resultsmentioning

confidence: 99%

“…In the DR, ventilation is most commonly administered through a T-piece with heated and humidified gases. The utilization of the T-piece is linked to higher survival rates without significant morbidities when compared to the selfinflating bag [11,12]. This device enables the delivery of constant PIP and PEEP but not a constant Vt, which is influenced by the lung compliance and inspiratory effort of the infant.…”

Section: Discussionmentioning

confidence: 99%

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A Survey of the Union of European Neonatal and Perinatal Societies on Neonatal Respiratory Care in Neonatal Intensive Care Units

Moretti,

Gizzi,

Gagliardi

et al. 2024

Children

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(1) Background: Our survey aimed to gather information on respiratory care in Neonatal Intensive Care Units (NICUs) in the European and Mediterranean region. (2) Methods: Cross-sectional electronic survey. An 89-item questionnaire focusing on the current modes, devices, and strategies employed in neonatal units in the domain of respiratory care was sent to directors/heads of 528 NICUs. The adherence to the “European consensus guidelines on the management of respiratory distress syndrome” was assessed for comparison. (3) Results: The response rate was 75% (397/528 units). In most Delivery Rooms (DRs), full resuscitation is given from 22 to 23 weeks gestational age. A T-piece device with facial masks or short binasal prongs are commonly used for respiratory stabilization. Initial FiO2 is set as per guidelines. Most units use heated humidified gases to prevent heat loss. SpO2 and ECG monitoring are largely performed. Surfactant in the DR is preferentially given through Intubation-Surfactant-Extubation (INSURE) or Less-Invasive-Surfactant-Administration (LISA) techniques. DR caffeine is widespread. In the NICUs, most of the non-invasive modes used are nasal CPAP and nasal intermittent positive-pressure ventilation. Volume-targeted, synchronized intermittent positive-pressure ventilation is the preferred invasive mode to treat acute respiratory distress. Pulmonary recruitment maneuvers are common approaches. During NICU stay, surfactant administration is primarily guided by FiO2 and SpO2/FiO2 ratio, and it is mostly performed through LISA or INSURE. Steroids are used to facilitate extubation and prevent bronchopulmonary dysplasia. (4) Conclusions: Overall, clinical practices are in line with the 2022 European Guidelines, but there are some divergences. These data will allow stakeholders to make comparisons and to identify opportunities for improvement.

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