Oxygen for the delivery room respiratory support of moderate-to-late preterm infants. An international survey of clinical practice from 21 countries
ACTA PAEDIATRICA(2021)
Abstract
Aim The aim of this study was to determine clinician opinion regarding oxygen management in moderate-late preterm resuscitation. Methods An anonymous online questionnaire was distributed through email/social messaging platforms to neonatologists in 21 countries (October 2020-March 2021) via REDCap. Results Of the 695 respondents, 69% had access to oxygen blenders and 90% had pulse oximeters. Respondents from high-income countries were more likely to have oxygen blenders than those from middle-income countries (72% vs. 66%). Most initiated respiratory support with FiO(2) 0.21 (43%) or 0.3 (36%) but only 45% titrated FiO(2) to target SpO(2). Most (89%) considered heart rate as a more important indicator of response than SpO(2). Almost all (96%) supported the need for well-designed trials to examine oxygenation in moderate-late preterm resuscitation. Conclusion Most clinicians resuscitated moderate-late preterm infants with lower initial FiO(2) but some cannot/will not target SpO(2) or titrate FiO(2). Most consider heart rate as a more important indicator of infant response than SpO(2).Large and robust clinical trials examining oxygen use for moderate-late preterm resuscitation, including long-term neurodevelopmental outcomes, are supported amongst clinicians.
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Key words
delivery room practice, moderate-late preterm infant, neonatal resuscitation, oxygen concentration, oxygen saturation
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