ArtPoster
TitelStatus quo of delivery mode, surfactant administration and ventilation setting in preterm infants in Germany, Austria and Switzerland – an online survey
TopicNeonatologie
Einleitung

Neonatal managements are a special focus of academic discussion, leading to mostly inconsistent results about what is best for the preterm infant. Therefore, national and international guidelines on the care of these infants often do not commit themselves to stringent recommendations. There is a need for evidence-based knowledge regarding the use of certain managements in extreme prematurity. The aim of this study was to assess the mode of delivery, surfactant administration, intubation for surfactant administration and the initial form of mechanical ventilation of preterm infants in Germany, Austria and Switzerland, in 2018, and to compare this data.

Patient/en und Methoden

An online-based survey, containing eight questions, was sent to neonatologists of perinatal centers in Germany, Austria and Switzerland, taking care of preterm infants < 32 gestational weeks (GW). Preterm infants were classified into the subgroups „26-31 GW“, and „< 26 GW“. In country and group comparisons, the rates of cesarean section, surfactant administration, intubation for surfactant administration and the initial ventilatory setting were analyzed.

Ergebnisse

The study included 2,051 German, 548 Austrian and 676 Swiss preterm infants, distributed to 46 perinatal centers. Austria (89.61%) has significant more cesarean section rates for the 26-31 GW subgroup than Germany (78.30%) and Switzerland (81.61%). Germany (85.99%) and Austria (80.33%) have significant more cesarean section rates than Switzerland (60.95%) for the < 26 GW subgroup. Germany (48.90%; 90.66%) and Austria (49.78%; 95.08%) both have significant more surfactant administration rates for both subgroups than Switzerland (42.03%; 74.29%). Intubation rates for surfactant administration are significantly different between all three countries for the subgroup < 26 GW (Austria: 20.65%; Germany: 68.18%; Switzerland 100%). National differences in the use of these managements exist. The initial form of mechanical ventilation varied from Synchronized Intermittent Mandatory Ventilation (SIMV) in Germany (57.89%) and Synchronized Intermittent Positive Pressure Ventilation (SIPPV) with Volume Guarantee (VG) in Austria (42.86%) to SIMV with VG and SIPPV with VG in Switzerland (both 40%).

Schlussfolgerung/Diskussion

The mode of delivery, surfactant administration, intubation for surfactant administration and the initial form of ventilation vary between the three countries and within the countries themselves, despite an identical state of scientific knowledge.

review
Erstautor*in ist unter 35 Jahre alt
Autor*in 1Elisa Hilz Paracelsus Medizinische Privatuniversität
Autor*in 2Martin Wald Division für Neonatologie der Universitätsklinik für Kinder- und Jugendheilkunde Salzburg