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Increase of caffeine and decrease of corticosteroids for extremely low‐birthweight infants with respiratory failure from 1997 to 2011
Author(s) -
Gerull Roland,
Manser Helen,
Küster Helmut,
Arenz Tina,
Nelle Mathias,
Arenz Stephan
Publication year - 2013
Publication title -
acta paediatrica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.772
H-Index - 115
eISSN - 1651-2227
pISSN - 0803-5253
DOI - 10.1111/apa.12419
Subject(s) - medicine , doxapram , pediatrics , sedation , dexamethasone , respiratory system , respiratory failure , caffeine , anesthesia
Aim To compare treatment strategies for respiratory failure in extremely low‐birthweight ( ELBW ) infants in G ermany in 1997 to G ermany, A ustria and S witzerland in 2011. Methods A detailed questionnaire about treatment strategies for ELBW infants was sent to all German centres treating ELBW infants in 1997. A follow‐up survey was conducted in 2011 in G ermany, A ustria and S witzerland. Results In 1997 and 2011, 63.6% and 66.2% of the hospitals responded. In 2011, the response rate was higher in S witzerland than in G ermany, and in university hospitals versus nonuniversity hospitals. Treatment strategies did not differ between university and nonuniversity hospitals as well as NICU s of different sizes in 2011. Differences between G ermany, A ustria and S witzerland were minimal. Administration of caffeine increased significantly, whereas theophylline and doxapram declined (all p < 0.001). While the use of dexamethasone decreased and the use of hydrocortisone increased, the overall use of corticosteroids declined (all p < 0.001). Between 1997 and 2011, therapy with inhalations and mucolytics decreased (both p < 0.001), whereas the use application of diuretics did not change significantly. In mechanically ventilated infants, the application of muscle relaxants and sedation declined significantly (p = 0.009 and p < 0.001), whereas analgesia use did not change. Conclusion Treatment strategies for respiratory failure in ELBW infants have changed significantly between 1997 and 2011.