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”
Authors Mann, C.;  Ward, C.; Grubb, M.; Hayes-Gill, B.; Crowe, J.; Marlow, N.; Sharkey, D.
Publication RESUSCITATION, Vol: 83 Issue: 5 pp: 607-611 January 2012
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.

Scroll to Top