Oxygen for the delivery room respiratory support of moderate-to-late preterm infants. An international survey of clinical practice from 21 countries

• Main Authors: James X. Sotiropoulos, Vishal Kapadia, Maximo Vento, Yacov Rabi, Ola D. Saugstad, R. Kishore Kumar, Georg M. Schmölzer, Huyan Zhang, Yuan Yuan, Gina Lim, Satoshi Kusuda, Takeshi Arimitsu, Tinh Thu Nguyen, Ratchada Kitsommart, Kee Thai Yeo, Ju Lee Oei
• Other Authors: Ulsan University Hospital
• Format: Article
• Published: 2022
• Subjects: Medicine
• Online Access: https://repository.li.mahidol.ac.th/handle/123456789/77531
• Institution: Mahidol University

Aim: The aim of this study was to determine clinician opinion regarding oxygen management in moderate-late preterm resuscitation. Methods: An anonymous online questionnaire was distributed through email/social messaging platforms to neonatologists in 21 countries (October 2020-March 2021) via REDCap. Results: Of the 695 respondents, 69% had access to oxygen blenders and 90% had pulse oximeters. Respondents from high-income countries were more likely to have oxygen blenders than those from middle-income countries (72% vs. 66%). Most initiated respiratory support with FiO2 0.21 (43%) or 0.3 (36%) but only 45% titrated FiO2 to target SpO2. Most (89%) considered heart rate as a more important indicator of response than SpO2. Almost all (96%) supported the need for well-designed trials to examine oxygenation in moderate-late preterm resuscitation. Conclusion: Most clinicians resuscitated moderate-late preterm infants with lower initial FiO2 but some cannot/will not target SpO2 or titrate FiO2. Most consider heart rate as a more important indicator of infant response than SpO2.Large and robust clinical trials examining oxygen use for moderate-late preterm resuscitation, including long-term neurodevelopmental outcomes, are supported amongst clinicians.