Izquierdo Montserrat, Iriondo Martín, Ruiz César, Zeballos Gonzalo, Sánchez Miguel, González Eva, Vento Máximo, Thió Marta
Division of Neonatology, BCNatal Hospital Sant Joan de Déu-Hospital Clínic, Esplugues de Llobregat (Barcelona), Spain.
Maternal and Infant Health and Development Research Network SAMID (RD 12/0026/0002), Health Research Institute Carlos III, Spanish Ministry of Economy and Competitiveness, Barcelona, Spain.
Acta Paediatr. 2017 Jun;106(6):897-903. doi: 10.1111/apa.13791. Epub 2017 Mar 19.
Neonatal resuscitation surveys have showed practice variations between countries, centres and levels of care. We evaluated delivery room practices after a nationwide neonatal resuscitation training programme focused on nontertiary centres.
A 2012 survey sent to all Spanish hospitals handling deliveries covered staff availability and training, equipment and practices in the delivery room and during transfers to neonatal intensive care units. The results from 98 centres that had completed a previous survey in 2007 were analysed by levels of care. Pearson's chi-square test was used to compare the proportions.
The following had significantly improved in 2012 compared to 2007: the availability of T-piece resuscitators (71.4% vs. 41.8%), plastic wraps (69.4% vs. 31.6%), gas blenders (79.6% vs. 40.8%), pulse oximetry (92.9% vs. 61.2%), use of continuous positive airway pressure (82.7% vs. 43.9%) (all p < 0.01), the availability of instructors (55.6% vs. 83.3%, p < 0.05) and neonatal resuscitation courses (40.8% vs. 79.6%, p < 0.05) in nontertiary centres. In 2012, the use of exhaled carbon dioxide detectors was <7% and endotracheal administration of adrenaline was >90%.
Neonatal resuscitation equipment and practices improved over time, but several aspects needed to be reinforced in training programmes, namely preterm infants' management, monitoring and adrenaline administration.
新生儿复苏调查显示，不同国家、中心及护理水平之间存在实践差异。我们评估了一项针对非三级中心的全国性新生儿复苏培训项目后的产房实践情况。
2012年向所有处理分娩的西班牙医院进行了一项调查，内容涵盖人员配备与培训、产房及转至新生儿重症监护病房期间的设备与实践情况。对98个在2007年完成过一项前期调查的中心的结果按护理水平进行了分析。采用Pearson卡方检验比较比例。
与2007年相比，2012年以下方面有显著改善：T形管复苏器的配备情况（71.4%对41.8%）、保鲜膜（69.4%对31.6%）、气体混合器（79.6%对40.8%）、脉搏血氧饱和度仪（92.9%对61.2%）、持续气道正压通气的使用（82.7%对43.9%）（所有p<0.01），非三级中心的教员配备情况（55.6%对83.3%，p<0.05）及新生儿复苏课程（40.8%对79.6%，p<0.05）。2012年，呼出二氧化碳探测器的使用<7%，气管内给予肾上腺素的情况>90%。
随着时间推移，新生儿复苏设备及实践有所改善，但培训项目中的几个方面仍需加强，即早产儿管理、监测及肾上腺素给药。
