Faculdade de Medicina. Universidade do Porto. Porto. Portugal.
Serviço de Neonatologia. Centro Hospitalar e Universitário de São João. Porto. Portugal.
Acta Med Port. 2024 May 2;37(5):342-354. doi: 10.20344/amp.20009.
Data from previous studies have demonstrated inconsistency between current evidence and delivery room resuscitation practices in developed countries. The primary aim of this study was to assess the quality of newborn healthcare and resuscitation practices in Portuguese delivery rooms, comparing current practices with the 2021 European Resuscitation Council guidelines. The secondary aim was to compare the consistency of practices between tertiary and non-tertiary centers across Portugal.
An 87-question survey concerning neonatal care was sent to all physicians registered with the Portuguese Neonatal Society via email. In order to compare practices between centers, participants were divided into two groups: Group A (level III and level IIb centers) and Group B (level IIa and I centers). A descriptive analysis of variables was performed in order to compare the two groups.
In total, 130 physicians responded to the survey. Group A included 91 (70%) and Group B 39 (30%) respondents. More than 80% of participants reported the presence of a healthcare professional with basic newborn resuscitation training in all deliveries, essential equipment in the delivery room, such as a resuscitator with a light and heat source, a pulse oximeter, and an O2 blender, and performing delayed cord clamping for all neonates born without complications. Less than 60% reported performing team briefing before deliveries, the presence of electrocardiogram sensors, end-tidal CO2 detector, and continuous positive airway pressure in the delivery room, and monitoring the neonate's temperature. Major differences between groups were found regarding staff attending deliveries, education, equipment, thermal control, umbilical cord management, vital signs monitoring, prophylactic surfactant administration, and the neonate's transportation out of the delivery room.
Overall, adherence to neonatal resuscitation international guidelines was high among Portuguese physicians. However, differences between guidelines and current practices, as well as between centers with different levels of care, were identified. Areas for improvement include team briefing, ethics, education, available equipment in delivery rooms, temperature control, and airway management. The authors emphasize the importance of continuous education to ensure compliance with the most recent guidelines and ultimately improve neonatal health outcomes.
先前的研究数据表明，在发达国家，当前的证据与产房复苏实践之间存在不一致性。本研究的主要目的是评估葡萄牙产房新生儿保健和复苏实践的质量，将当前实践与 2021 年欧洲复苏理事会指南进行比较。次要目的是比较葡萄牙各地三级和非三级中心之间实践的一致性。
通过电子邮件向所有在葡萄牙新生儿学会注册的医生发送了一份包含 87 个问题的新生儿护理调查。为了比较中心之间的实践，参与者被分为两组：A 组（三级和二级 b 级中心）和 B 组（二级 a 级和 I 级中心）。对变量进行描述性分析，以比较两组。
共有 130 名医生对调查做出了回应。A 组包括 91 名（70%）和 B 组 39 名（30%）的受访者。超过 80%的参与者报告说，在所有分娩中都有一名具有基本新生儿复苏培训的医疗保健专业人员，产房内有基本设备，如带有光源和热源的复苏器、脉搏血氧仪和 O2 混合器，并对所有无并发症出生的新生儿进行延迟脐带结扎。不到 60%的人报告说在分娩前进行了团队简报，产房内存在心电图传感器、呼气末 CO2 探测器和持续气道正压通气，以及监测新生儿的体温。在工作人员参与分娩、教育、设备、体温控制、脐带管理、生命体征监测、预防性表面活性剂给药以及新生儿离开产房的运输等方面，两组之间存在较大差异。
总体而言，葡萄牙医生对新生儿复苏国际指南的遵循度较高。然而，发现了指南与当前实践之间以及不同护理水平中心之间的差异。需要改进的领域包括团队简报、道德、教育、产房内可用设备、体温控制和气道管理。作者强调了持续教育的重要性，以确保遵守最新指南，并最终改善新生儿健康结果。
