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Trends in respiratory management of transferred very preterm infants in the last two decades
Author(s) -
Cavallin Francesco,
Doglioni Nicoletta,
Brombin Laura,
Lolli Elisabetta,
Loddo Cristina,
Cavicchiolo Maria Elena,
Mardegan Veronica,
Magarotto Mariella,
Mainini Nicoletta,
Nardo Daniel,
Peloso Rebecca Luisa,
Piva Daniele,
Priante Elena,
Valerio Enrico,
Baraldi Eugenio,
Trevisanuto Daniele
Publication year - 2021
Publication title -
pediatric pulmonology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.866
H-Index - 106
eISSN - 1099-0496
pISSN - 8755-6863
DOI - 10.1002/ppul.25532
Subject(s) - medicine , pediatrics , respiratory system , supplemental oxygen , mechanical ventilation , continuous positive airway pressure , gestational age , anesthesia , pregnancy , biology , obstructive sleep apnea , genetics
Background Among infants needing urgent transfer after birth, very preterm infants are a high‐risk sub‐group requiring special attention. This study aimed to assess trends in early respiratory management in a large series of very preterm infants undergoing postnatal transfer. Methods Trends in patient characteristics and early respiratory management were assessed in 798 very preterm infants who were transferred by the Eastern Veneto Neonatal Emergency Transport Service in 2000–2019. Trends were analyzed using joinpoint regression analysis and summarized as annual percentage changes (APCs). Results Proportion of neonates with birth weight less than 1 kg decreased from 33% to 16% (APC −3.82%). Use of nasal‐continuous‐positive‐airway pressure increased (at call: APC 15.39%; during transfer: APC 15.60%), while use of self‐inflating bag (at call: APC −12.09%), oxygen therapy (at call: APC −13.00%; during transfer: APC −23.77%) and mechanical ventilation (at call: APC −2.71%; during transfer: APC −2.99%) decreased. Use of oxygen concentrations at 21% increased (at call: APC 6.26%; during transfer: APC 7.14%), while oxygen concentrations above 40% decreased (at call: APC −5.73%; at transfer APC −8.89%). Surfactant administration at call increased (APC 3%–10%), while surfactant administration when arriving at referring hospital remained around 7‐11% (APC 2.55%). Conclusion Relevant trends toward “gentle” approaches in early respiratory management of very preterm infants undergoing postnatal transfer occurred during the last twenty years. In addition, the proportion of transferred extremely low birth weight infants halved. Clinicians and stakeholders should consider such information when allocating assets to both hospitals and transfer services and planning regional perinatal programs.