Cucerea Manuela, Simon Marta, Stoicescu Silvia Maria, Blaga Ligia Daniela, Galiș Radu, Stamatin Maria, Olariu Gabriela, Ognean Maria Livia
George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, Romania.
Carol Davila University of Medicine and Pharmacy, Bucuresti, Romania.
J Crit Care Med (Targu Mures). 2024 Jan 30;10(1):19-29. doi: 10.2478/jccm-2024-0010. eCollection 2024 Jan.
This study is part of a European survey on delivery room practices endorsed by the Union of European Neonatal and Perinatal Societies (UENPS) and the Romanian Association of Neonatology (ANR). The aim of our study was to evaluate the current neonatal resuscitation practices in Romanian maternity hospitals and to compare the results between level III and level II centers.
The questionnaire was distributed through ANR by email link to heads of neonatal departments of 53 Romanian maternity hospitals with more than one thousand of births per year between October 2019 and September 2020, having 2018 as the reference year for data collection.
The overall response rate to the questionnaire was 62.26% (33/53), 83.33% (15/18) for level-III centers and 51.43% (18/35) for level-II centers. Of the responding centers, 18 (54,54%) were academic hospitals, 15 (83,33%) were level III and 3 (16,67%) level II hospitals. In 2018, responding centers reported 81.139 births representing 42.66% of all Romanian births (190.170). There were significant differences between level-III and level-II maternity hospitals regarding the number of births in 2018 (3028.73±1258.38 vs 1983.78±769.99; P=0.006), lowest GA of routinely assisted infants in delivery room (25.07±3.03 weeks vs 30.44±3.28, P<0.001), inborn infants with BW<1500 admitted to neonatal intensive care unit (NICU) in 2018 (66.86±39.14 g vs 22.87±31.50 g; P=0.002), and antenatal counseling of parents before the delivery of a very preterm infant or an infant with expected problems (60% vs 22.2%; P=0.027). There were no significant differences of thermal and umbilical cord management, positive pressure delivery, heart rate assessment between responding centers.
The adherence to new guidelines was high among responding centers regarding thermal and umbilical cord management, initial FiO, but aspects like antenatal counseling, EKG monitoring, laryngeal mask, and heated/humidified gases availability and administration, and simulation-based training require further implementation.
本研究是一项欧洲产房实践调查的一部分，该调查得到了欧洲新生儿和围产医学学会联盟（UENPS）和罗马尼亚新生儿学会（ANR）的认可。我们研究的目的是评估罗马尼亚产科医院当前的新生儿复苏实践，并比较三级和二级中心的结果。
通过ANR以电子邮件链接的方式将问卷分发给罗马尼亚53家每年分娩量超过1000例的产科医院的新生儿科主任，数据收集以2018年为参考年份，时间跨度为2019年10月至2020年9月。
问卷的总体回复率为62.26%（33/53），三级中心为83.33%（15/18），二级中心为51.43%（18/35）。在回复的中心中，18家（54.54%）是学术医院，其中15家（83.33%）是三级医院，3家（16.67%）是二级医院。2018年，回复中心报告的分娩量为81139例，占罗马尼亚所有分娩量（190170例）的42.66%。2018年，三级和二级产科医院在分娩量（3028.73±1258.38 vs 1983.78±769.99；P=0.006）、产房常规辅助婴儿的最低孕周（25.07±3.03周 vs 30.44±3.28，P<0.001）、2018年入住新生儿重症监护病房（NICU）的出生体重<1500g的新生儿数量（66.86±39.14例 vs 22.87±31.50例；P=0.002）以及极早产儿或预期有问题的婴儿分娩前对父母的产前咨询方面（60% vs 22.2%；P=0.027）存在显著差异。回复中心在体温和脐带管理、正压通气、心率评估方面没有显著差异。
回复中心在体温和脐带管理、初始吸氧浓度方面对新指南的依从性较高，但产前咨询、心电图监测、喉罩以及加热/加湿气体的可用性和使用、基于模拟的培训等方面需要进一步落实。
