Department of Neonatology, Westmead Hospital, Westmead, NSW, Australia.
The University of Sydney, Sydney, NSW, Australia.
Pediatr Res. 2023 May;93(6):1701-1709. doi: 10.1038/s41390-022-02297-0. Epub 2022 Sep 8.
Are thermoregulation and golden hour practices in extremely preterm (EP) infants comparable across the world? This study aims to describe these practices for EP infants based on the neonatal intensive care unit's (NICUs) geographic region, country's income status and the lowest gestational age (GA) of infants resuscitated.
The Director of each NICU was requested to complete the e-questionnaire between February 2019 and August 2021.
We received 848 responses, from all geographic regions and resource settings. Variations in most thermoregulation and golden hour practices were observed. Using a polyethylene plastic wrap, commencing humidity within 60 min of admission, and having local protocols were the most consistent practices (>75%). The odds for the following practices differed in NICUs resuscitating infants from 22 to 23 weeks GA compared to those resuscitating from 24 to 25 weeks: respiratory support during resuscitation and transport, use of polyethylene plastic wrap and servo-control mode, commencing ambient humidity >80% and presence of local protocols.
Evidence-based practices on thermoregulation and golden hour stabilisation differed based on the unit's region, country's income status and the lowest GA of infants resuscitated. Future efforts should address reducing variation in practice and aligning practices with international guidelines.
A wide variation in thermoregulation and golden hour practices exists depending on the income status, geographic region and lowest gestation age of infants resuscitated. Using a polyethylene plastic wrap, commencing humidity within 60 min of admission and having local protocols were the most consistent practices. This study provides a comprehensive description of thermoregulation and golden hour practices to allow a global comparison in the delivery of best evidence-based practice. The findings of this survey highlight a need for reducing variation in practice and aligning practices with international guidelines for a comparable health care delivery.
全球范围内，极低出生体重儿（extremely preterm，EP）的体温调节和黄金时间实践是否具有可比性？本研究旨在根据新生儿重症监护病房（neonatal intensive care unit，NICU）的地理位置、国家收入状况和复苏的最低胎龄（gestational age，GA），描述 EP 婴儿的这些实践。
要求每个 NICU 的主任在 2019 年 2 月至 2021 年 8 月期间完成电子问卷。
我们收到了来自所有地理区域和资源环境的 848 份回复。大多数体温调节和黄金时间实践存在差异。使用聚乙烯塑料包裹物、在入院后 60 分钟内开始湿度调节和使用本地方案是最一致的实践（>75%）。与复苏 24-25 周 GA 婴儿的 NICU 相比，复苏 22-23 周 GA 婴儿的以下实践的可能性不同：复苏期间和转运时的呼吸支持、使用聚乙烯塑料包裹物和伺服控制模式、开始使用>80%的环境湿度和存在本地方案。
基于单位所在地区、国家收入状况和复苏的最低 GA，体温调节和黄金时间稳定化的循证实践存在差异。未来的努力应该致力于减少实践中的差异，并使实践与国际指南保持一致。
根据复苏婴儿的收入状况、地理位置和最低胎龄，体温调节和黄金时间实践存在很大差异。使用聚乙烯塑料包裹物、在入院后 60 分钟内开始湿度调节和使用本地方案是最一致的实践。本研究全面描述了体温调节和黄金时间的实践，以允许在提供最佳循证实践方面进行全球比较。这项调查的结果强调了减少实践中的差异并使实践与国际指南保持一致的必要性，以提供可比的医疗保健服务。
