Premium
Neonatal Golden Hour: A survey of Australian and New Zealand Neonatal Network units' early stabilisation practices for very preterm infants
Author(s) -
Hodgson Kate A,
Owen Louise S,
Lui Kei,
Shah Vibhuti
Publication year - 2021
Publication title -
journal of paediatrics and child health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.631
H-Index - 76
eISSN - 1440-1754
pISSN - 1034-4810
DOI - 10.1111/jpc.15360
Subject(s) - medicine , neonatal intensive care unit , gestational age , pediatrics , intensive care , supplemental oxygen , continuous positive airway pressure , oxygen saturation , intensive care medicine , anesthesia , pregnancy , oxygen , chemistry , genetics , organic chemistry , obstructive sleep apnea , biology
Aim To identify current ‘Golden Hour’ practices for initial stabilisation of very preterm infants <32 weeks' gestational age (GA) within tertiary neonatal intensive care units (NICUs) in the Australian and New Zealand Neonatal Network (ANZNN). Methods A 76‐question survey regarding delivery room (DR) and NICU stabilisation practices was distributed electronically to directors of tertiary perinatal NICUs in the ANZNN in January 2019. Responses were categorised into GA subgroups: 23–24, 25–27 and 28–31 weeks' GA. Results The response rate was 100% (24/24 units). Delayed cord clamping (DCC) was practised ‘always’ or ‘often’ by 21 units (88%). All units used oximetry to target oxygen saturations, and 23/24 (96%) commenced resuscitation in <40% oxygen. Ten units (42%) routinely used DR electrocardiography monitoring. CPAP was preferred as primary respiratory support in one‐third of units for infants born 23–24 weeks' GA, compared with 19 units (79%) at 25–27 weeks' GA and 23 units (96%) at 28–31 weeks' GA. DR skin‐to‐skin care was uncommon, particularly at lower GAs. Five units (21%) used minimally invasive surfactant therapy for non‐intubated infants at 23–24 weeks' GA, 13 units (54%) at 25–27 weeks' GA and 16 units (67%) at 28–31 weeks' GA. Conclusions Most Golden Hour stabilisation practices align with international guidelines. Consistency exists with respect to DCC, oxygen saturation targeting and primary CPAP use for infants 25 weeks' GA and above. Where evidence is less certain, practices vary across ANZNN NICUs. Time targets for stabilisation measures may help standardise practice for this population.