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Resuscitation of preterm infants in the Philippines: a national survey of resources and practice

OBJECTIVE: There is a high incidence of preterm birth in low-income and middle-income countries where healthcare resources are often limited and may influence decision making. We aimed to explore the interplay between resource limitations and resuscitation practices for extremely preterm infants (EP...

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Autores principales: Hayden, Dean, Villanueva-Uy, Maria Esterlita, Mendoza, Maria Katrina, Wilkinson, Dominic
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7063403/
https://www.ncbi.nlm.nih.gov/pubmed/31201255
http://dx.doi.org/10.1136/archdischild-2019-316951
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author Hayden, Dean
Villanueva-Uy, Maria Esterlita
Mendoza, Maria Katrina
Wilkinson, Dominic
author_facet Hayden, Dean
Villanueva-Uy, Maria Esterlita
Mendoza, Maria Katrina
Wilkinson, Dominic
author_sort Hayden, Dean
collection PubMed
description OBJECTIVE: There is a high incidence of preterm birth in low-income and middle-income countries where healthcare resources are often limited and may influence decision making. We aimed to explore the interplay between resource limitations and resuscitation practices for extremely preterm infants (EPIs) in neonatal intensive care units (NICUs) across the Philippines. METHODS: We conducted a national survey of NICUs in the Philippines. Institutions were classified according to sector (private/public), region and level. Respondents were asked about unit capacity, availability of ventilators and surfactant, resuscitation practices and estimated survival rates for EPIs of different gestational ages. RESULTS: Respondents from 103/228 hospitals completed the survey (response rate 45%). Public hospitals reported more commonly experiencing shortages of ventilators than private hospitals (85%vs23%, p<0.001). Surfactant was more likely to be available in city hospitals than regional/district hospitals (p<0.05) and in hospitals classified as Level III/IV than I/II (p<0.05). The financial capacity of parents was a major factor influencing treatment options. Survival rates for EPIs were estimated to be higher in private than public institutions. Resuscitation practice varied; active treatment was generally considered optional for EPIs from 25 weeks’ gestation and usually provided after 27–28 weeks’ gestation. CONCLUSION: Our survey revealed considerable disparities in NICU resource availability between different types of hospitals in the Philippines. Variation was observed between hospitals as to when resuscitation would be provided for EPIs. National guidelines may generate greater consistency of care yet would need to reflect the variable context for decisions in the Philippines.
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spelling pubmed-70634032020-03-23 Resuscitation of preterm infants in the Philippines: a national survey of resources and practice Hayden, Dean Villanueva-Uy, Maria Esterlita Mendoza, Maria Katrina Wilkinson, Dominic Arch Dis Child Fetal Neonatal Ed Original Research OBJECTIVE: There is a high incidence of preterm birth in low-income and middle-income countries where healthcare resources are often limited and may influence decision making. We aimed to explore the interplay between resource limitations and resuscitation practices for extremely preterm infants (EPIs) in neonatal intensive care units (NICUs) across the Philippines. METHODS: We conducted a national survey of NICUs in the Philippines. Institutions were classified according to sector (private/public), region and level. Respondents were asked about unit capacity, availability of ventilators and surfactant, resuscitation practices and estimated survival rates for EPIs of different gestational ages. RESULTS: Respondents from 103/228 hospitals completed the survey (response rate 45%). Public hospitals reported more commonly experiencing shortages of ventilators than private hospitals (85%vs23%, p<0.001). Surfactant was more likely to be available in city hospitals than regional/district hospitals (p<0.05) and in hospitals classified as Level III/IV than I/II (p<0.05). The financial capacity of parents was a major factor influencing treatment options. Survival rates for EPIs were estimated to be higher in private than public institutions. Resuscitation practice varied; active treatment was generally considered optional for EPIs from 25 weeks’ gestation and usually provided after 27–28 weeks’ gestation. CONCLUSION: Our survey revealed considerable disparities in NICU resource availability between different types of hospitals in the Philippines. Variation was observed between hospitals as to when resuscitation would be provided for EPIs. National guidelines may generate greater consistency of care yet would need to reflect the variable context for decisions in the Philippines. BMJ Publishing Group 2020-03 2019-06-14 /pmc/articles/PMC7063403/ /pubmed/31201255 http://dx.doi.org/10.1136/archdischild-2019-316951 Text en © Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY. Published by BMJ. http://creativecommons.org/licenses/by/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.
spellingShingle Original Research
Hayden, Dean
Villanueva-Uy, Maria Esterlita
Mendoza, Maria Katrina
Wilkinson, Dominic
Resuscitation of preterm infants in the Philippines: a national survey of resources and practice
title Resuscitation of preterm infants in the Philippines: a national survey of resources and practice
title_full Resuscitation of preterm infants in the Philippines: a national survey of resources and practice
title_fullStr Resuscitation of preterm infants in the Philippines: a national survey of resources and practice
title_full_unstemmed Resuscitation of preterm infants in the Philippines: a national survey of resources and practice
title_short Resuscitation of preterm infants in the Philippines: a national survey of resources and practice
title_sort resuscitation of preterm infants in the philippines: a national survey of resources and practice
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7063403/
https://www.ncbi.nlm.nih.gov/pubmed/31201255
http://dx.doi.org/10.1136/archdischild-2019-316951
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