National surveys of UK and Italian neonatal units highlighted significant differences in the use of non-invasive respiratory support.

AIM: This study compared how non-invasive respiratory support (NRS) was provided in neonatal units in Italy and the UK.

METHODS

An NRS questionnaire was sent to tertiary neonatal centres, identified by national societies, from November 2015 to May 2016.

RESULTS

Responses were received from 49/57 (86%) UK units and 103/115 (90%) Italian units. NRS was started in the delivery room by 61% of UK units and 85% of Italian units. In neonatal intensive care units, 33% of UK units used nasal high-flow therapy (HFT) as primary support, compared to 3% in Italy. Nasal continuous positive airway pressure (CPAP) was used in 57% of UK units and 90% of Italian units. The commonest starting flow rate on nasal HFT for term and preterm infants was 6 L/min in the UK, while Italian units mainly used this flow for term infants. In the UK, 67% of units decreased nasal HFT by 1 L/min per day. In Italy, infants on nasal CPAP were weaned by 1 cm H2 O per day in 39% of units.

CONCLUSION

The way that NRS was managed for very preterm infants differed between the UK and Italy, reflecting a lack of evidence on optimal NRS and the use of local protocols.