Marked variation in newborn resuscitation practice: A national survey in the UK

Mann, Chantelle; Ward, Carole; Grubb, Mark; Hayes-Gill, Barrie; Crowe, John; Marlow, Neil; Sharkey, Don

doi:10.1016/j.resuscitation.2012.01.002

« Previous Next »Resuscitation
Volume 83, Issue 5 , Pages 607-611, May 2012

Marked variation in newborn resuscitation practice: A national survey in the UK☆

Chantelle Mann
- Division of Academic Child Health, University of Nottingham, Nottingham, UK
Carole Ward
- Division of Academic Child Health, University of Nottingham, Nottingham, UK
Mark Grubb
- Division of Electrical Systems and Applied Optics, University of Nottingham, UK
Barrie Hayes-Gill
- Division of Electrical Systems and Applied Optics, University of Nottingham, UK
John Crowe
- Division of Electrical Systems and Applied Optics, University of Nottingham, UK
Neil Marlow
- Institute for Women's Health, University College London, UK
Don Sharkey
- Division of Academic Child Health, University of Nottingham, Nottingham, UK
- Corresponding author at: Neonatal Medicine, Division of Academic Child Health, University of Nottingham, E Floor, East Block, Queen's Medical Centre Campus, Derby Road, Nottingham, NG7 2UH, UK. Tel.: +44 11582 30602.

Received 20 October 2011; received in revised form 9 December 2011; accepted 5 January 2012. published online 13 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.

Abbreviations: NICU, neonatal intensive care unit, DR, delivery room, ANNP, advanced neonatal nurse practitioner, PEEP, positive end expiratory pressure, CPAP, continuous positive airway pressure, NDAU, Neonatal Data Analysis Unit, NS, not statistically significant

Keywords: Neonatal resuscitation, Survey, Practice variation

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☆ A Spanish translated version of the summary of this article appears as Appendix in the final online version at doi:10.1016/j.resuscitation.2012.01.002.

PII: S0300-9572(12)00009-3

doi:10.1016/j.resuscitation.2012.01.002

« Previous Next »Resuscitation
Volume 83, Issue 5 , Pages 607-611, May 2012

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