Opinions of Brazilian resuscitation instructors regarding resuscitation in the delivery room of extremely preterm newborns
Objective: To describe the opinions of pediatricians who teach resuscitation in Brazil on initiating and limiting the delivery room resuscitation of extremely preterm infants. Method: Cross‐sectional study with electronic questionnaire (Dec/2011–Sep/2013) sent to pediatricians who are instructors of...
| Main Authors: | , , |
|---|---|
| Format: | Article |
| Language: | Portuguese |
| Published: |
Brazilian Society of Pediatrics
2016-11-01
|
| Series: | Jornal de Pediatria (Versão em Português) |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2255553616300623 |
| _version_ | 1811332805489065984 |
|---|---|
| author | Cristiane Ribeiro Ambrósio Maria Fernanda Branco de Almeida Ruth Guinsburg |
| author_facet | Cristiane Ribeiro Ambrósio Maria Fernanda Branco de Almeida Ruth Guinsburg |
| author_sort | Cristiane Ribeiro Ambrósio |
| collection | DOAJ |
| description | Objective: To describe the opinions of pediatricians who teach resuscitation in Brazil on initiating and limiting the delivery room resuscitation of extremely preterm infants.
Method: Cross‐sectional study with electronic questionnaire (Dec/2011–Sep/2013) sent to pediatricians who are instructors of the Neonatal Resuscitation Program of the Brazilian Society of Pediatrics, containing three hypothetical clinical cases: (1) decision to start the delivery room resuscitation; (2) limitation of neonatal intensive care after delivery room resuscitation; (3) limitation of advanced resuscitation in the delivery room. For each case, it was requested that the instructor indicate the best management for each gestational age between 23 and 26 weeks. A descriptive analysis was performed.
Results: 560 (82%) instructors agreed to participate. Only 9% of the instructors reported the existence of written guidelines at their hospital regarding limitations of delivery room resuscitation. At 23 weeks, 50% of the instructors would initiate delivery room resuscitation procedures. At 26 weeks, 2% would decide based on birth weight and/or presence of fused eyelids. Among the participants, 38% would re‐evaluate their delivery room decision and limit the care for 23‐week neonates in the neonatal intensive care unit. As for advanced resuscitation, 45% and 4% of the respondents, at 23 and 26 weeks, respectively, would not apply chest compressions and/or medications.
Conclusion: Difficulty can be observed regarding the decision to not resuscitate a preterm infant with 23 weeks of gestational age. At the same time, a small percentage of pediatricians would not resuscitate neonates of unquestionable viability at 26 weeks of gestational age in the delivery room. |
| first_indexed | 2024-04-13T16:42:28Z |
| format | Article |
| id | doaj.art-188ccb8e55164f9c96d6191907df5d0f |
| institution | Directory Open Access Journal |
| issn | 2255-5536 |
| language | Portuguese |
| last_indexed | 2024-04-13T16:42:28Z |
| publishDate | 2016-11-01 |
| publisher | Brazilian Society of Pediatrics |
| record_format | Article |
| series | Jornal de Pediatria (Versão em Português) |
| spelling | doaj.art-188ccb8e55164f9c96d6191907df5d0f2022-12-22T02:39:10ZporBrazilian Society of PediatricsJornal de Pediatria (Versão em Português)2255-55362016-11-0192660961510.1016/j.jpedp.2016.06.001Opinions of Brazilian resuscitation instructors regarding resuscitation in the delivery room of extremely preterm newbornsCristiane Ribeiro Ambrósio0Maria Fernanda Branco de Almeida1Ruth Guinsburg2Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, BrasilUniversidade Federal de São Paulo (UNIFESP), Escola Paulista de Medicina, Divisão de Medicina Neonatal, São Paulo, SP, BrasilUniversidade Federal de São Paulo (UNIFESP), Escola Paulista de Medicina, Divisão de Medicina Neonatal, São Paulo, SP, BrasilObjective: To describe the opinions of pediatricians who teach resuscitation in Brazil on initiating and limiting the delivery room resuscitation of extremely preterm infants. Method: Cross‐sectional study with electronic questionnaire (Dec/2011–Sep/2013) sent to pediatricians who are instructors of the Neonatal Resuscitation Program of the Brazilian Society of Pediatrics, containing three hypothetical clinical cases: (1) decision to start the delivery room resuscitation; (2) limitation of neonatal intensive care after delivery room resuscitation; (3) limitation of advanced resuscitation in the delivery room. For each case, it was requested that the instructor indicate the best management for each gestational age between 23 and 26 weeks. A descriptive analysis was performed. Results: 560 (82%) instructors agreed to participate. Only 9% of the instructors reported the existence of written guidelines at their hospital regarding limitations of delivery room resuscitation. At 23 weeks, 50% of the instructors would initiate delivery room resuscitation procedures. At 26 weeks, 2% would decide based on birth weight and/or presence of fused eyelids. Among the participants, 38% would re‐evaluate their delivery room decision and limit the care for 23‐week neonates in the neonatal intensive care unit. As for advanced resuscitation, 45% and 4% of the respondents, at 23 and 26 weeks, respectively, would not apply chest compressions and/or medications. Conclusion: Difficulty can be observed regarding the decision to not resuscitate a preterm infant with 23 weeks of gestational age. At the same time, a small percentage of pediatricians would not resuscitate neonates of unquestionable viability at 26 weeks of gestational age in the delivery room.http://www.sciencedirect.com/science/article/pii/S2255553616300623Newborn infantBioethicsResuscitation ordersCardiopulmonary resuscitationFetal viability |
| spellingShingle | Cristiane Ribeiro Ambrósio Maria Fernanda Branco de Almeida Ruth Guinsburg Opinions of Brazilian resuscitation instructors regarding resuscitation in the delivery room of extremely preterm newborns Jornal de Pediatria (Versão em Português) Newborn infant Bioethics Resuscitation orders Cardiopulmonary resuscitation Fetal viability |
| title | Opinions of Brazilian resuscitation instructors regarding resuscitation in the delivery room of extremely preterm newborns |
| title_full | Opinions of Brazilian resuscitation instructors regarding resuscitation in the delivery room of extremely preterm newborns |
| title_fullStr | Opinions of Brazilian resuscitation instructors regarding resuscitation in the delivery room of extremely preterm newborns |
| title_full_unstemmed | Opinions of Brazilian resuscitation instructors regarding resuscitation in the delivery room of extremely preterm newborns |
| title_short | Opinions of Brazilian resuscitation instructors regarding resuscitation in the delivery room of extremely preterm newborns |
| title_sort | opinions of brazilian resuscitation instructors regarding resuscitation in the delivery room of extremely preterm newborns |
| topic | Newborn infant Bioethics Resuscitation orders Cardiopulmonary resuscitation Fetal viability |
| url | http://www.sciencedirect.com/science/article/pii/S2255553616300623 |
| work_keys_str_mv | AT cristianeribeiroambrosio opinionsofbrazilianresuscitationinstructorsregardingresuscitationinthedeliveryroomofextremelypretermnewborns AT mariafernandabrancodealmeida opinionsofbrazilianresuscitationinstructorsregardingresuscitationinthedeliveryroomofextremelypretermnewborns AT ruthguinsburg opinionsofbrazilianresuscitationinstructorsregardingresuscitationinthedeliveryroomofextremelypretermnewborns |