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Updated Guidelines for Resuscitation, Stabilization and Res-piratory Distress Syndrome Early Management in Extremely Preterm Infants–Impact on Outcomes
Cucerea, M.; Simon, M.; Anciuc-Crauciuc, M.; Marian, R.; Rusneac, M.; Ognean, M.L. 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. J. Clin. Med.2024, 13, 1103.
Cucerea, M.; Simon, M.; Anciuc-Crauciuc, M.; Marian, R.; Rusneac, M.; Ognean, M.L. 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. J. Clin. Med. 2024, 13, 1103.
Cucerea, M.; Simon, M.; Anciuc-Crauciuc, M.; Marian, R.; Rusneac, M.; Ognean, M.L. 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. J. Clin. Med.2024, 13, 1103.
Cucerea, M.; Simon, M.; Anciuc-Crauciuc, M.; Marian, R.; Rusneac, M.; Ognean, M.L. 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. J. Clin. Med. 2024, 13, 1103.
Abstract
Background: Survival and outcome of extremely preterm (EP) infants have improved due to changes in the management of stabilization at birth and respiratory distress syndrome. Methods: In a retrospective study conducted at an academic perinatal level III center in Romania, we compared the effects of different protocols on the early outcomes of EP infants of two different periods (2008-2012 vs. 2018 vs. 2022). Two subgroups were studied in each period, based on gestational age (GA), 22-25 weeks, and 26-28 weeks, excluding those with significant congenital anomalies or missing data. Results: 270 EP infants were included in the study (121/149), with a mean GA 26.1±1.6/26.7±1.1 weeks. Significant improvements were found during period II regarding initial FiO2 (40% vs. 100%; <0.001), nCPAP (55.7% vs. 19.0%; p<0.001) at birth, early rescue surfactant administration (65.8% vs. 34.7%; p<0.001), need of mechanical ventilation (58.4% vs. 98.3%; p<0.001). Survival rates of EP infants significantly improved from 41.3% to 72.5%, particularly in the 26-28 weeks subgroup (63.8% to 83%). The frequency of severe IVH decreased in period II from 30.6% to 14.1%, while the rates of BPD were lower in period II (23.4% vs. 36.6%; p=0.045), in the 26-28 weeks subgroup. We found improvements but no significant differences in NEC, sepsis, PVL, ROP, or PDA frequencies. Conclusions: Using updated guidelines and protocols is crucial for improving outcomes.
Medicine and Pharmacology, Pediatrics, Perinatology and Child Health
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