[The Europe against immature lung (EURAIL) project. Strategies for the prevention and treatment of lung immaturity in neonates].
OBJECTIVE
To determine clinical practice variability in the prevention and postnatal treatment of lung immaturity in Spain.


METHODS
Cross-sectional study within a larger study in 13 European countries. Data were obtained from the medical records of all very low birth weight (VLBW) infants born in participating centers, without other instrumentation.


RESULTS
A questionnaire was sent to 213 centers. Seventy-two (34 %) responded, with 162,157 births (40 % of total births in 1999). Eight percent of infants were of low birth weight, 1.2 % (2,015) of very low birth weight and 0.45 % were of extremely low birth weight. A total of 52.2 % of VLBW infants received at least one dose of prenatal steroids, 28.8 % received a full course and 9.3 % received more than one cycle. All centres used surfactant and 76.8 % had a written protocol. Forty-one percent of VLBW infants were intubated, 47.6 % required mechanical ventilation for more than 6 hours, and 5 % underwent continuous positive airway pressure. A total of 80.4 % used postnatal steroids, half of them for chronic lung disease prevention, and 83.4 % used steroids to treat this disease. Steroids were most frequently indicated at 7-14 days of life for 3-9 days. The most important causes of neonatal morbidity were chronic lung disease in 14 %, ductus arteriosus in 16.7 %, intraventricular hemorrhage in 8.5 %, and necrotizing enterocolitis in 7.3 %.


CONCLUSIONS
Prenatal exposure to steroids was low. Repeat cycles and postnatal steroid use to prevent chronic lung disease was high. Recent scientific evidence on the use of pre- and postnatal steroids should be more widely disseminated.
Valls i Soler
A
A
Unidad Neonatal y de Investigación. Departamento de Pediatría. Hospital de Cruces. Facultad de Medicina. Universidad del País Vasco/EHU. Barakaldo. Bilbao. Spain. enadolf@eresmas.net
Páramo Andrés
S
S
Fernández-Ruanova
B
B
Morcillo Sopena
F
F
Monleón Alegre
F J
FJ
Carretero Díaz
V
V
Marín Herrero
J
J
D001623:Betamethasone / Q000627:therapeutic use; D003430:Cross-Sectional Studies; D005060:Europe; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000453:epidemiology / Q000517:prevention & control* / Q000628:therapy; D008168:Lung / Q000002:abnormalities*; D011663:Pulmonary Surfactants / Q000627:therapeutic use; D013030:Spain; D011795:Surveys and Questionnaires
D011663:Pulmonary Surfactants; D001623:Betamethasone