Neonatal Resuscitation Practices in Portuguese Delivery Rooms: A Cross-Sectional Study
DOI:
https://doi.org/10.20344/amp.20009Keywords:
Delivery Rooms, Infant, Newborn, Portugal, Resuscitation, Surveys and QuestionnairesAbstract
Introduction: Data from previous studies have demonstrated inconsistency between current evidence and delivery room resuscitation practices in developed countries. The primary aim of this study was to assess the quality of newborn healthcare and resuscitation practices in Portuguese delivery rooms, comparing current practices with the 2021 European Resuscitation Council guidelines. The secondary aim was to compare the consistency of practices between tertiary and non-tertiary centers across Portugal.
Methods: An 87-question survey concerning neonatal care was sent to all physicians registered with the Portuguese Neonatal Society via email. In order to compare practices between centers, participants were divided into two groups: Group A (level III and level IIb centers) and Group B (level IIa and I centers). A descriptive analysis of variables was performed in order to compare the two groups.
Results: In total, 130 physicians responded to the survey. Group A included 91 (70%) and Group B 39 (30%) respondents. More than 80% of participants reported the presence of a healthcare professional with basic newborn resuscitation training in all deliveries, essential equipment in the delivery room, such as a resuscitator with a light and heat source, a pulse oximeter, and an O2 blender, and performing delayed cord clamping for all neonates born without complications. Less than 60% reported performing team briefing before deliveries, the presence of electrocardiogram sensors, end-tidal CO2 detector, and continuous positive airway pressure in the delivery room, and monitoring the neonate’s temperature. Major differences between groups were found regarding staff attending deliveries, education, equipment, thermal control, umbilical cord management, vital signs monitoring, prophylactic surfactant administration, and the neonate’s transportation out of the delivery room.
Conclusion: Overall, adherence to neonatal resuscitation international guidelines was high among Portuguese physicians. However, differences between guidelines and current practices, as well as between centers with different levels of care, were identified. Areas for improvement include team briefing, ethics, education, available equipment in delivery rooms, temperature control, and airway management. The authors emphasize the importance of continuous education to ensure compliance with the most recent guidelines and ultimately improve neonatal health outcomes.
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References
Wyckoff MH, Wyllie J, Aziz K, de Almeida MF, Fabres JW, Fawke J, et al. Neonatal life support 2020 international consensus on cardiopulmonary resuscitation and emergency cardiovascular care science with treatment recommendations. Resuscitation. 2020;156:A156-87.
Madar J, Roehr CC, Ainsworth S, Ersdal H, Morley C, Rudiger M, et al. European resuscitation council guidelines 2021: newborn resuscitation and support of transition of infants at birth. Resuscitation. 2021;161:291-326.
World Health Organization. Newborns: improving survival and wellbeing. 2020. [cited 2023 Jan 14]. Available from: https://www.who.int/news-room/fact-sheets/detail/newborns-reducing-mortality.
Mann C, Ward C, Grubb M, Hayes-Gill B, Crowe J, Marlow N, et al. Marked variation in newborn resuscitation practice: a national survey in the UK. Resuscitation. 2012;83:607-11.
El-Naggar W, McNamara PJ. Delivery room resuscitation of preterm infants in Canada: current practice and views of neonatologists at level III centers. J Perinatol. 2012;32:491-7.
Iriondo M, Thió M, Burón E, Salguero E, Aguayo J, Vento M, et al. A survey of neonatal resuscitation in Spain: gaps between guidelines and practice. Acta Paediatr. 2009;98:786-91.
Rocha G, Saldanha J, Macedo I, Areias A, Graça A, Tomé T. Condições de assistência ao recém-nascido na sala de partos: inquérito nacional (2009). Acta Med Port. 2011;2:213-22.
Wyllie J, Bruinenberg J, Roehr CC, Rudiger M, Trevisanuto D, Urlesberger B. European Resuscitation Council guidelines for resuscitation 2015: section 7. Resuscitation and support of transition of babies at birth. Resuscitation. 2015;95:249-63.
Mitchell A, Niday P, Boulton J, Chance G, Dulberg C. A prospective clinical audit of neonatal resuscitation practices in Canada. Adv Neonatal Care. 2002;2:316-26.
Bensouda B, Boucher J, Mandel R, Lachapelle J, Ali N. 24/7 in house attending staff coverage improves neonatal short-term outcomes: a retrospective study. Resuscitation. 2018;122:25-8.
Fulbrook P, Latour J, Albarran J, de Graaf W, Lynch F, Devictor D, et al. The presence of family members during cardiopulmonary resuscitation: European federation of Critical Care Nursing associations, European Society of Paediatric and Neonatal Intensive Care and European Society of Cardiology Council on Cardiovascular Nursing and Allied Professions Joint Position Statement. Eur J Cardiovasc Nurs. 2007;6:255-8.
Dainty KN, Atkins DL, Breckwoldt J, Maconochie I, Schexnayder SM, Skrifvars MB, et al. Family presence during resuscitation in paediatric and neonatal cardiac arrest: a systematic review. Resuscitation. 2021;162:20-34.
Gizzi C, Trevisanuto D, Gagliardi L, Vertecchi G, Ghirardello S, Di Fabio S, et al. Neonatal resuscitation practices in Italy: a survey of the Italian Society of Neonatology (SIN) and the Union of European Neonatal and Perinatal Societies (UENPS). Ital J Pediatr. 2022;48:81.
Sawyer T, Lee HC, Aziz K. Anticipation and preparation for every delivery room resuscitation. Semin Fetal Neonatal Med. 2018;23:312-20.
Trevisanuto D, Testoni D, de Almeida MF. Maintaining normothermia: why and how? Semin Fetal Neonatal Med. 2018;23:333-9.
Moore ER, Bergman N, Anderson GC, Medley N. Early skin-to-skin contact for mothers and their healthy newborn infants. Cochrane Database Syst Rev. 2016;11:CD003519.
Hooper SB, Polglase GR, Roehr CC. Cardiopulmonary changes with aeration of the newborn lung. Paediatr Respir Rev. 2015;16:47-50.
Fogarty M, Osborn DA, Askie L, Seidler AL, Hunter K, Lui K, et al. Delayed vs early umbilical cord clamping for preterm infants: a systematic review and meta-analysis. Am J Obstet Gynecol. 2018;218:1-18.
Sheikh M, Nanda V, Kumar R, Khilfeh M. Neonatal outcomes since the implementation of no routine endotracheal suctioning of meconiumstained nonvigorous neonates. Am J Perinatol. 2022 (in press). doi: 10.1055/a-1950-2672.
Ng EH, Shah V. Guidelines for surfactant replacement therapy in neonates. Paediatr Child Health. 2021;26:35-41.
Sweet DG, Carnielli VP, Greisen G, Hallman M, Klebermass-Schrehof K, Ozek E, et al. European Consensus guidelines on the management of respiratory distress syndrome: 2022 Update. Neonatology. 2023;120:3-23.
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