Estratégias de suporte ventilatório no recém-nascido pré-termo – Inquérito nacional (2008)

Neonatal respiratory support strategies in the intensive care unit: an Italian survey

We carried out a survey of current practices of neonatal respiratory support in neonatal intensive care units (NICUs) in Italy with the aim of comparing the current reality with evidence from the literature. We sent a questionnaire by email to the 103 level III neonatal units in Italy. There was a 61 % (73/120) response rate to the questionnaire. We found that synchronized intermittent positive pressure ventilation is mostly used in infants in the acute phase of respiratory distress syndrome (RDS), while the majority of the units prefer volume-targeted ventilation for those in the weaning phase. Nasal continuous positive airway pressure is the most commonly used non-invasive mode of respiratory support, both in the acute and post-extubation phase of RDS. Surfactant is mainly given as rescue treatment. Infants receive caffeine before extubation and analgesia under mechanical ventilation, while post-natal steroids are given after the first week of life in the majority of the units. In conclusion, respiratory support strategies in Italian NICUs are frequently evidence-based. However, since there are areas where this does not occur, we suggest that focused interventions take place on these areas to help improve clinical practice and increase their adherence to evidence-based medical criteria.

Italian survey of neonatal respiratory support strategies

Although the management of respiratory distress syndrome (RDS) in preterm infants has been characterized by significant progress in recent years, it is difficult to translate the research results into clinical practice. Previous surveys have demonstrated that in some areas, the current management of RDS does not reflect evidence from randomized trials. Therefore, the Pulmonology Study Group of the Italian Society of Neonatology decided to perform a similar survey in Italy with the aim of identifying possible aspects of respiratory management of preterm infants with RDS that merit improvement, and of suggesting focused interventions for their resolution.