Variation of Delivery Room Resuscitation Practice in the UK


Title “Variation of Delivery Room Resuscitation Practice in the UK”
Authors Ward, C.; Grubb, M.; Crowe, J.; Hayes-Gill, B.; Marlow, N.; Sharkey, D.
Publication European Academy of Paediatric Societies, October 2010, Copenhagen.
Abstract Background: Advances in neonatal intensive care have improved outcomes for term and preterm infants. Delivery room (DR) management of newborn infants remains basic although recent advances include the use of air for resuscitation, plastic wraps/bags for temperature preservation, DR CPAP and pulse oximetry. No data exist on DR management of newborns in the UK.


Aim: Establish current DR management of newborn infants in the UK.


Methods: A telephone/email/postal survey of DR management in UK neonatal units during 2009. 192 units were surveyed and 171 (89%) responded (65 Level III and 106 Level II/I units). Comparisons were made between level III (intensive care) and level II/I units (high dependency/special care).


Results: There were differences in DR management with level III units using significantly more ventilation devices with PEEP (95% vs 88%, P< 0.05) and delivery room CPAP (43% vs 16%, P< 0.0001). Significantly more level III units commenced resuscitation in air (49% vs 30%, P=0.01) and fewer used 100% oxygen (12% vs 40%, P< 0.0001). The use of pulse oximeters (III=23% vs II/I=12%), plastic wraps/bags (III=97% vs II/I=96%), DR surfactant (III=92% vs II/I=83%) and elective intubation of preterm infants (III=83% vs II/I=73%) were not statistically different.


Conclusions: These important data highlight significant variance of DR management for newborn infants in the UK with level III units adopting a more evidence-based practice. Furthermore, these data differ markedly from those reported in other developed countries. These discrepancies between resuscitation guidelines, DR management and poor evidence-base need urgent attention.



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