Changes in resuscitation practice at birth.
OBJECTIVE
To investigate secular changes in neonatal resuscitation at birth.


METHODS
Single centre observational study of 17 890 infants born between May 1993 and April 1997. T-piece ventilation was introduced in April 1995.


METHODS
Rates and modes of ventilatory resuscitation, early neonatal encephalopathy, neonatal convulsions, and meconium aspiration syndrome; 1 and 5 min Apgar scores; maternal age and method of delivery; paediatric attendance at delivery and resuscitation.


RESULTS
The rate of all forms of ventilatory resuscitation fell during the four year period from 11.0% to 8.9%. The rate of intubation fell from 2.4% to 1.2%. A reduced rate of intubation was seen at all gestations of 30 weeks and above. There was no difference in rates of relevant neonatal problems during the period except for a reduction in neonatal convulsions. The introduction of T-piece ventilation did not contribute to the reduction in intubation in a logistic regression model that included time trend.


CONCLUSIONS
A marked reduction in the rate of intubation was observed, without any reduction in the efficacy of resuscitation. This may reflect improvements and changing emphasis in resuscitation training.
Allwood
A C L
AC
Derriford Hospital, Plymouth, UK.
Madar
R J
RJ
Baumer
J H
JH
Readdy
L
L
Wright
D
D
D000328:Adult; D001034:Apgar Score; D001927:Brain Diseases / Q000453:epidemiology; D016009:Chi-Square Distribution; D036861:Delivery, Obstetric / Q000706:statistics & numerical data; D004630:Emergencies / Q000453:epidemiology; D004739:England / Q000453:epidemiology; D020936:Epilepsy, Benign Neonatal / Q000453:epidemiology; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007442:Intubation, Intratracheal / Q000592:standards / Q000706:statistics & numerical data / Q000639:trends*; D008423:Maternal Age; D008471:Meconium Aspiration Syndrome / Q000453:epidemiology; D018743:Perinatal Care / Q000379:methods / Q000592:standards / Q000639:trends*; D011364:Professional Practice / Q000592:standards / Q000639:trends*; D012044:Regression Analysis; D012121:Respiration, Artificial / Q000379:methods / Q000706:statistics & numerical data / Q000639:trends*