Marked variation in newborn resuscitation practice: a national survey in the UK

Resuscitation. 2012 May;83(5):607-11. doi: 10.1016/j.resuscitation.2012.01.002. Epub 2012 Jan 12.

Abstract

Background: Although international newborn resuscitation guidance has been in force for some time, there are no UK data on current newborn resuscitation practices.

Objective: Establish delivery room (DR) resuscitation practices in the UK, and identify any differences between neonatal intensive care units (NICU), and other local neonatal services.

Methods: We conducted a structured two-stage survey of DR management, among UK neonatal units during 2009-2010 (n=192). Differences between NICU services (tertiary level) and other local neonatal services (non-tertiary) were analysed using Fisher's exact and Student's t-tests.

Results: There was an 89% response rate (n=171). More tertiary NICUs institute DR CPAP than non-tertiary units (43% vs. 16%, P=0.0001) though there was no significant difference in frequency of elective intubation and surfactant administration for preterm babies. More tertiary units commence DR resuscitation in air (62% vs. 29%, P<0.0001) and fewer in 100% oxygen (11% vs. 41%, P<0.0001). Resuscitation of preterm babies in particular, commences with air in 56% of tertiary units. Significantly more tertiary units use DR pulse oximeters (58% vs. 29%, P<0.01) and titrate oxygen based on saturations. Almost all services use occlusive wrapping to maintain temperature for preterm infants.

Conclusions: In the UK, there are many areas of good evidence based DR practice. However, there is marked variation in management, including between units of different designation, suggesting a need to review practice to fulfil new resuscitation guidance, which will have training and resource implications.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Body Temperature
  • Continuous Positive Airway Pressure / statistics & numerical data
  • Delivery Rooms
  • Humans
  • Infant, Newborn
  • Intensive Care, Neonatal / methods*
  • Oxygen Inhalation Therapy / statistics & numerical data
  • Resuscitation / methods*
  • Resuscitation / standards
  • Surveys and Questionnaires
  • United Kingdom