title: Delivery room management of extremely low birthweight infants shows marked geographical variations in Italy.
abstract: OBJECTIVE
  To evaluate any geographical variations in practice and adherence to international guidelines for early delivery room management of extremely low birthweight (ELBW) infants in the North, Centre and South of Italy.
  
  
  METHODS
  A questionnaire was sent to all 107 directors of Italian level III centres between April and August 2012.
  
  
  RESULTS
  There was a 92% (n = 98) response rate. A polyethylene bag/wrap was used by 54 centres (55.1%), with the highest rate in Northern Italy (77.5%) and the lowest rate in Southern (37.7%) areas. In Northern regions, one centre (2.5%) said it used oxygen concentrations >40% to initiate positive pressure ventilation in ELBW infants. These proportions were higher in the Central (14.3%) and Southern (16.2%) areas. A T-piece device for positive pressure ventilation was more frequently available in the Northern (95%) units than in those in the Central (66.7%) and Southern (69.4%) regions. A median of 13% (IQR: 5%-30%) of ELBW infants received chest compressions at birth in Italy: 5%, 18% and 22% in Northern, Central and Southern units, respectively.
  
  
  CONCLUSIONS
  In Italy, delivery room management of ELBW infants showed marked geographical variations. Implementation of national training programmes could increase adherence to the guidelines and reduce such discordance.
authors.affiliation: Children and Women's Health Department, Medical School University of Padua Azienda, Padua, Italy.
authors.forename: Daniele
authors.initials: D
authors.lastname: Trevisanuto
authors.forename: Irene
authors.initials: I
authors.lastname: Satariano
authors.forename: Nicoletta
authors.initials: N
authors.lastname: Doglioni
authors.forename: Giulio
authors.initials: G
authors.lastname: Criscoli
authors.forename: Francesco
authors.initials: F
authors.lastname: Cavallin
authors.forename: Camilla
authors.initials: C
authors.lastname: Gizzi
authors.forename: Claudio
authors.initials: C
authors.lastname: Martano
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Ciralli
authors.forename: Flaminia
authors.initials: F
authors.lastname: Torielli
authors.forename: Paolo E
authors.initials: PE
authors.lastname: Villani
authors.forename: Sandra
authors.initials: S
authors.lastname: Di Fabio
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Quartulli
authors.forename: Luigi
authors.initials: L
authors.lastname: Giannini
mesh_terms: D003696:Delivery Rooms / Q000458:organization & administration / Q000592:standards / Q000706:statistics & numerical data*; D019468:Disease Management; D005843:Geography; D019983:Guideline Adherence / Q000706:statistics & numerical data; D019538:Health Care Surveys; D006801:Humans; D007223:Infant; D007226:Infant Mortality / Q000639:trends; D052577:Infant, Extremely Low Birth Weight; D007231:Infant, Newborn; D007558:Italy; D010043:Outcome and Process Assessment, Health Care / Q000706:statistics & numerical data; D011175:Positive-Pressure Respiration / Q000706:statistics & numerical data; D017410:Practice Guidelines as Topic / Q000592:standards; D012121:Respiration, Artificial / Q000379:methods / Q000592:standards / Q000706:statistics & numerical data*; D012151:Resuscitation / Q000379:methods / Q000592:standards / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D016019:Survival Analysis
keywords: Delivery room; Guidelines; Preterm infant; Resuscitation; Survey