Use of oxygen for delivery room neonatal resuscitation in non-tertiary Australian and New Zealand hospitals: A survey of current practices, opinions and equipment
Use of oxygen for delivery room neonatal resuscitation in non-tertiary Australian and New Zealand hospitals: A survey of current practices, opinions and equipment
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DOI：
10.1111/j.1440-1754.2012.02545.x
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发表时间：
2012-09-01
影响因子：
1.7
通讯作者：
Oei, Ju Lee
中科院分区：
文献类型：
--
作者：
Bhola, Kavita;Lui, Kei;Oei, Ju Lee
背景：产房用纯氧或100%氧气复苏缺氧新生儿可引起氧化毒性并增加死亡率。因此，目前的国际复苏指南建议明智地使用氧气。然而，这需要对工作人员进行教育，并需要特殊设备，而这些在非三级妇产医院可能是不具备的，因为大多数分娩是在这些医院进行的。目的：确定澳大利亚和新西兰（ANZ）非三级妇产医院目前对使用空气和混合氧进行新生儿产房复苏的态度、做法和可用设备。方法：通过个人电话联系后，通过邮件和电子邮件发送结构化问卷。ANZ共确定了203家合格医院。一个月后，为无回复者进行了第二次邮寄。应答者：最终应答率为64%（n= 130：70%医生，30%助产士）。大多数（121，93%）受访者了解澳大利亚复苏理事会的建议，但只有五分之一的医院有能力提供混合氧，38%的医院在分娩时使用脉搏血氧仪。只有24家（18.5%）医院有指南。68家（57%）医院将使用空气复苏足月婴儿，而35家（31%）医院将使用空气复苏早产婴儿。大多数（111，91%）主张使用混合氧，尽管缺乏设施。结论：只有五分之一的ANZ非三级妇产医院有能力用空气或混合氧复苏新生儿。大多数人都知道目前的建议，并同意使用较少的氧气将有利于这一目的。建议进一步研究实施这些准则所需的必要基础设施。
Background: Delivery room resuscitation of hypoxic newborn infants with pure or 100% oxygen causes oxidative toxicity and increases mortality. Current international resuscitation guidelines therefore recommend that oxygen be used judiciously. However, this requires staff education and special equipment that may not be available in non-tertiary maternity hospitals where the majority of births occur. Aim: To determine current attitudes, practices and available equipment for the use of air and blended oxygen for newborn delivery room resuscitation in non-tertiary maternity hospitals of Australia and New Zealand (ANZ). Methods: Structured questionnaires sent by mail and e-mail after personal phone contact. A total of 203 eligible hospitals in ANZ were identified. A second mailing was conducted a month later for non-responders. Responders: Final response rate was 64% (n= 130: 70% physicians, 30% midwives). The majority (121, 93%) of respondents were aware of Australian Resuscitation Council recommendations, but only one in five hospitals had the capacity to deliver blended oxygen and 38% used pulse oximeters at delivery. Only 24 (18.5%) hospitals had guidelines. Air would be used by 68 (57%) hospitals to resuscitate term infants compared to 35 (31%) for preterm infants. Most (111, 91%) advocated the use of blended oxygen despite the lack of facilities. Conclusion: Only one in five ANZ non-tertiary maternity hospitals had the capacity to resuscitate newborn infants with air or blended oxygen. Most are aware of current recommendations and agreed that the use of less oxygen would be beneficial for this purpose. Further study into the necessary infrastructure required to implement these guidelines are recommended.