Neonatal respiratory care practice among level III and IV NICUs in New England

期刊论文
发表日期：

2024年3月11日

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Helen Healy,
Bernadette Levesque,
Kristen T. Leeman,
Ruben Vaidya,
Emily Whitesel,
Sherman Chu,
Justin Goldstein,
Shruti Gupta,
Bharati Sinha,
Munish Gupta,
Megan Aurora

摘要

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 FiO₂ requirement of 0.3–0.4 and a CPAP of 6–7 cmH₂O, 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.