Marked variation in delivery room management in very preterm infants()

BACKGROUND: The International Liaison Committee on Resuscitation (ILCOR) and UK Resuscitation Council (UKRC) updated guidance on newborn resuscitation in late 2010. OBJECTIVES: To describe delivery room (DR) practice in stabilisation following very preterm birth (<32 weeks gestation) in the UK. METHODS: We emailed a national survey of current DR stabilisation practice of very preterm infants to all UK delivery units and conducted telephone follow-up calls. RESULTS: We obtained 197 responses from 199 units (99%) and complete data from 186 units. Tertiary units administered surfactant in the DR (93% vs. 78%, P = 0.01), instituted DR CPAP (77% vs. 50%, P = 0.0007), provided PEEP in the delivery room (91% vs. 69%, P = 0.0008), and started resuscitation in air or blended oxygen (91% vs. 78%, P = 0.04) more often than non-tertiary units. Routine out of hours consultant attendance at very preterm birth was more common in tertiary units (82% vs. 55%, P = 0.0005). CONCLUSIONS: Marked variation in DR stabilisation practice of very preterm infants persisted one year after the publication of revised UKRC guidance. Delivery room care provided in non-tertiary units was less consistent with current international guidance.