Neonatal Respiratory Care Practice Among Level III and IV NICUs in New England

Overview

Journal J Perinatol

Specialty Gynecology & Obstetrics

Date 2024 Mar 12

PMID 38467745

Authors

Helen Healy

Bernadette Levesque

Kristen T Leeman

Ruben Vaidya

Emily Whitesel

Sherman Chu

Justin Goldstein

Shruti Gupta

Bharati Sinha

Munish Gupta

Megan Aurora

Affiliations

Soon will be listed here.

Abstract

Objectives: To assess respiratory care guidelines and explore variations in management of very low birth weight (VLBW) infants within a collaborative care framework. Additionally, to gather clinical leaders' perspectives on guidelines and preferences for ventilation modalities.

Study Design: Leaders from each NICU participated in a practice survey regarding the prevalence of unit clinical guidelines, and management, at many stages of care.

Results: Units have an average of 4.3 (±2.1) guidelines, of 9 topics queried. Guideline prevalence was not associated with practice or outcomes. An FiO requirement of 0.3-0.4 and a CPAP of 6-7 cmHO, are the most common thresholds for surfactant administration, which is most often done after intubation, and followed by weaning from ventilatory support. Volume targeted ventilation is commonly used. Extubation criteria vary widely.

Conclusions: Results identify trends and areas of variation and suggest that the presence of guidelines alone is not predictive of outcome.

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