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Войти в исследования Respiratory Practices to Prevent or Treat Evolving Bronchopulmonary Dysplasia: A European Survey.
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van de Loo Moniek, Onland Wes, Hutten Jeroen, Lavizzari Anna, Heiring Christian, Aldecoa-Bilbao Victoria, Ehrhardt Harald, Cetinkaya Merih, Szczapa Tomasz, Sartorius Victor, Rocha Gustavo, Werther Tobias, Soukka Hanna, Danhaive Olivier, Roehr Charles C, Cucerea Manuela, Calkovska Andrea, Dimitriou Gabriel, Barzilay Bernard, Filipovic-Grcic Boris, Hentschel Roland, Thome Ulrich, Bohlin Kajsa, Lista Gianluca, Schulzke Sven, Plavka Richard, Tameliene Rasa, O'Donnell Colm P F, Klingenberg Claus, Sindelar Richard, van Kaam Anton H, ESPR Pulmonary Research Consortium
Аннотация
STUDY DESIGN: Between March and July 2024, a web-based survey was sent to European NICUs caring for infants born preterm with gestational age <28 weeks.
RESULTS: We received replies from 447 of 721 (62%) NICUs across 24 European countries. Almost 16% of NICUs routinely intubate at birth, especially if the gestational age is <24 weeks. During transition most NICUs use continuous positive airway pressure ≥5 cmH2O and start with an FiO2 0.3. Volume-targeted ventilation is the primary ventilation mode in 60% of the NICUs. Permissive hypercapnia is a common practice. Higher SpO2 target limits have been adopted, although alarm settings vary across NICUs. Caffeine is routinely started (96%). Surfactant is used in all NICUs, mostly rescue (74%) via less invasive administration (81%). Prophylactic inhaled nitric oxide is not used. Treatment of patent ductus arteriosus varies; half of NICUs pharmacologically treat patent ductus arteriosus early, based on echocardiographic findings. Ureaplasma screening is done in 22% of NICUs. Most (97%) NICUs use postnatal corticosteroids, with dexamethasone being the preferred drug (65%) and starting 2-3 weeks after birth. Only 5% use corticosteroids prophylactically. After 2-3 weeks, diuretics are used frequently, inhaled corticosteroids/bronchodilators to a much lesser extent.
CONCLUSIONS: This large survey shows considerable practice variation in preventing and treating evolving bronchopulmonary dysplasia across Europe, especially for interventions with limited evidence.