title: Neonatal respiratory support strategies in the intensive care unit: an Italian survey.
abstract: We carried out a survey of current practices of neonatal respiratory support in neonatal intensive care units (NICUs) in Italy with the aim of comparing the current reality with evidence from the literature. We sent a questionnaire by email to the 103 level III neonatal units in Italy. There was a 61 % (73/120) response rate to the questionnaire. We found that synchronized intermittent positive pressure ventilation is mostly used in infants in the acute phase of respiratory distress syndrome (RDS), while the majority of the units prefer volume-targeted ventilation for those in the weaning phase. Nasal continuous positive airway pressure is the most commonly used non-invasive mode of respiratory support, both in the acute and post-extubation phase of RDS. Surfactant is mainly given as rescue treatment. Infants receive caffeine before extubation and analgesia under mechanical ventilation, while post-natal steroids are given after the first week of life in the majority of the units. In conclusion, respiratory support strategies in Italian NICUs are frequently evidence-based. However, since there are areas where this does not occur, we suggest that focused interventions take place on these areas to help improve clinical practice and increase their adherence to evidence-based medical criteria.
authors.affiliation: Department of Surgical and Medical Critical Care, Division of Neonatology, Careggi University Hospital of Florence, Viale Morgagni, 85, 50134, Florence, Italy. cdani@unifi.it
authors.forename: Carlo
authors.initials: C
authors.lastname: Dani
authors.forename: Cecilia
authors.initials: C
authors.lastname: Bresci
authors.forename: Gianluca
authors.initials: G
authors.lastname: Lista
authors.forename: Claudio
authors.initials: C
authors.lastname: Martano
authors.forename: Francesco
authors.initials: F
authors.lastname: Messina
authors.forename: Claudio
authors.initials: C
authors.lastname: Migliori
authors.forename: Giovanni
authors.initials: G
authors.lastname: Vento
mesh_terms: D019983:Guideline Adherence / Q000706:statistics & numerical data*; D019538:Health Care Surveys; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D015931:Intensive Care, Neonatal / Q000379:methods* / Q000592:standards / Q000706:statistics & numerical data; D007558:Italy; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D012127:Respiratory Distress Syndrome, Newborn / Q000628:therapy*; D012138:Respiratory Therapy / Q000295:instrumentation / Q000379:methods* / Q000592:standards / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires