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

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 in...

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Main Authors: Mann, Chantelle, Ward, Carole, Grubb, Mark, Hayes-Gill, Barrie, Crowe, John, Marlow, Neil, Sharkey, Don
Format: Article
Published: Elsevier 2012
Online Access:https://eprints.nottingham.ac.uk/2710/
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author Mann, Chantelle
Ward, Carole
Grubb, Mark
Hayes-Gill, Barrie
Crowe, John
Marlow, Neil
Sharkey, Don
author_facet Mann, Chantelle
Ward, Carole
Grubb, Mark
Hayes-Gill, Barrie
Crowe, John
Marlow, Neil
Sharkey, Don
author_sort Mann, Chantelle
building Nottingham Research Data Repository
collection Online Access
description 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.
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spelling nottingham-27102024-08-15T15:33:19Z https://eprints.nottingham.ac.uk/2710/ Marked variation in newborn resuscitation practice: a national survey in the UK Mann, Chantelle Ward, Carole Grubb, Mark Hayes-Gill, Barrie Crowe, John Marlow, Neil Sharkey, Don 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. Elsevier 2012-05 Article PeerReviewed Mann, Chantelle, Ward, Carole, Grubb, Mark, Hayes-Gill, Barrie, Crowe, John, Marlow, Neil and Sharkey, Don (2012) Marked variation in newborn resuscitation practice: a national survey in the UK. Resuscitation, 83 (5). pp. 607-611. ISSN 0300-9572 http://www.resuscitationjournal.com/article/S0300-9572(12)00009-3/abstract doi:10.1016/j.resuscitation.2012.01.002 doi:10.1016/j.resuscitation.2012.01.002
spellingShingle Mann, Chantelle
Ward, Carole
Grubb, Mark
Hayes-Gill, Barrie
Crowe, John
Marlow, Neil
Sharkey, Don
Marked variation in newborn resuscitation practice: a national survey in the UK
title Marked variation in newborn resuscitation practice: a national survey in the UK
title_full Marked variation in newborn resuscitation practice: a national survey in the UK
title_fullStr Marked variation in newborn resuscitation practice: a national survey in the UK
title_full_unstemmed Marked variation in newborn resuscitation practice: a national survey in the UK
title_short Marked variation in newborn resuscitation practice: a national survey in the UK
title_sort marked variation in newborn resuscitation practice: a national survey in the uk
url https://eprints.nottingham.ac.uk/2710/
https://eprints.nottingham.ac.uk/2710/
https://eprints.nottingham.ac.uk/2710/