Survey on Delivery Room Ventilation of Preterm and Term Infants in German‐Speaking Countries
Julian C. Brozek, Christian Maiwald, Paul‐Philip Warth, Christoph M. Rüegger, Lukas P. Mileder, Michael Wagner, Vincent D. Gaertner, Maxi Kaufmann, Christian F. Poets, Laila SpringerABSTRACT
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 cmH 2 O (5.0–6.0 cmH 2 O), for MLP 6.0 cmH 2 O (5.0–6.0 cmH 2 O), and for very preterm infants 6.0 cmH 2 O (5.0–8.0 cmH 2 O). 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.