Updated Clinical Practice Guidelines in Resuscitation and the Management of Respiratory Distress Syndrome in Extremely Preterm Infants during Two Epochs in Romania: Impact on Outcomes

Adequate perinatal management is essential in caring for extremely preterm (EP) infants. We aimed to evaluate and compare the impact of different protocols on short-term outcomes. A retrospective study was conducted on EP infants in a Romanian perinatal tertiary center during 2008-2012 and 2018-2022...

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Bibliographic Details
Published in:Journal of clinical medicine 2024-02, Vol.13 (4), p.1103
Main Authors: Cucerea, Manuela, Simon, Marta, Anciuc-Crauciuc, Mădălina, Marian, Raluca, Rusneac, Monika, Ognean, Maria Livia
Format: Article
Language:English
Subjects:
Caffeine
Care and treatment
Continuous positive airway pressure
Diagnosis
Gestational age
Health aspects
Hematology
Infants
Infants (Premature)
Intubation
Lung diseases
Morbidity
Mortality
Neonatal care
Newborn babies
Patient outcomes
Premature babies
Pulse oximetry
Respiratory distress syndrome
Sepsis
Surfactants
Survival analysis
Ventilators
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Summary:Adequate perinatal management is essential in caring for extremely preterm (EP) infants. We aimed to evaluate and compare the impact of different protocols on short-term outcomes. A retrospective study was conducted on EP infants in a Romanian perinatal tertiary center during 2008-2012 and 2018-2022. Data on 270 EP infants (121 in period I, 149 in period II) were analyzed collectively and stratified into two subgroups by gestational age. Initial FiO administration (100% vs. 40%% < 0.001), lung recruitment at birth (19.0% vs. 55.7% < 0.001), early rescue surfactant administration (34.7% vs. 65.8%; < 0.001), and the mechanical ventilation rate (98.3% vs. 58.4%; < 0.001) were significantly improved during period II. Survival rates of EP infants significantly improved from 41.3% to 72.5%, particularly in the 26-28 weeks subgroup (63.8% to 83%). Compared to period I, the overall frequency of severe IVH decreased in period II from 30.6% to 14.1%; also, BPD rates were lower (36.6% vs. 23.4%; = 0.045) in the 26-28 weeks subgroup. Despite improvements, there were no significant differences in the frequencies of NEC, sepsis, PVL, ROP, or PDA. Implementing evidence-based clinical guidelines can improve short-term outcomes.
ISSN:2077-0383
2077-0383
DOI:10.3390/jcm13041103