title: Changes over time in delivery room management of extremely low birth weight infants in Italy.
abstract: OBJECTIVE
  To identify changes in practice between two historical periods (2002 vs. 2011) in early delivery room (DR) management of ELBWI in Italian tertiary centres.
  
  
  METHODS
  A questionnaire was sent to the directors of all Italian level III centres between April and August 2012. The same questionnaire was used in a national survey conducted in 2002. Among the participating centres, those that filled the questionnaire in both study periods were selected for inclusion in this study.
  
  
  RESULTS
  There was an 88% (n=76/86) and 92% (n=98/107) response rate in the 2 surveys, respectively. The two groups overlapped for 64 centres. During the study period, the use of polyethylene bags/wraps increased from 4.7% to 59.4% of the centres. The units using 100% oxygen concentrations to initiate resuscitation of ELBWI decreased from 56.2% to 6.2%. The approach to respiratory management was changed for the majority of the examined issues: positive pressure ventilation (PPV) administered through a T-piece resuscitator (from 14.0% to 85.9%); use of PEEP during PPV (from 35.9% to 95.3%); use of CPAP (from 43.1% to 86.2%). From 2002 to 2011, the percentages of ELBWI intubated in DR decreased in favor of those managed with N-CPAP; ELBWI receiving chest compressions and medications at birth were clinically comparable.
  
  
  CONCLUSIONS
  During the two study periods, the approach to the ELBWI at birth significantly changed. More attention was devoted to temperature control, use of oxygen, and less-invasive respiratory support. Nevertheless, some relevant interventions were not uniformly followed by the surveyed centres.
authors.affiliation: Children and Women's Health Department Medical School, University of Padua, Azienda Ospedaliera Padova, 35128 Padua, Italy. Electronic address: trevo@pediatria.unipd.it.
authors.forename: Daniele
authors.initials: D
authors.lastname: Trevisanuto
authors.affiliation: Children and Women's Health Department Medical School, University of Padua, Azienda Ospedaliera Padova, 35128 Padua, Italy.
authors.forename: Irene
authors.initials: I
authors.lastname: Satariano
authors.affiliation: Children and Women's Health Department Medical School, University of Padua, Azienda Ospedaliera Padova, 35128 Padua, Italy.
authors.forename: Nicoletta
authors.initials: N
authors.lastname: Doglioni
authors.affiliation: Italian Army - Signals and Information Technology HQ - C4 Systems Integration Development, Treviso, Italy.
authors.forename: Giulio
authors.initials: G
authors.lastname: Criscoli
authors.affiliation: Independent Statistician, Padua, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Cavallin
authors.affiliation: Neonatal Intensive Care Unit, Pediatric and Neonatal Department, "S.Giovanni Calibita" Fatebenefratelli Hospital - Isola Tiberina, 00186 Rome, Italy.
authors.forename: Camilla
authors.initials: C
authors.lastname: Gizzi
authors.affiliation: Neonatal Intensive Care Unit, Pediatric Department, Medical School, University of Turin, Azienda Ospedaliera, OIRM-S.Anna, 10126 Torino, Italy.
authors.forename: Claudio
authors.initials: C
authors.lastname: Martano
authors.affiliation: Neonatal Intensive Care Unit, Department of Mother and Infant Science, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, 20122 Milan, Italy.
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Ciralli
authors.affiliation: Neonatology Unit, University of Genova, Azienda Ospedaliera San Martino IRCCS - IST National Institute on Cancer Research, 16100 Genova, Italy.
authors.forename: Flaminia
authors.initials: F
authors.lastname: Torielli
authors.affiliation: Neonatal Intensive Care Unit, Maternal and Pediatric Department, Carlo Poma Hospital, Mantova, Italy.
authors.forename: Paolo Ernesto
authors.initials: PE
authors.lastname: Villani
authors.affiliation: Neonatal Intensive Care Unit, Department of Mother and Infant Science, "San Salvatore" Hospital, L'Aquila, Italy.
authors.forename: Sandra
authors.initials: S
authors.lastname: Di Fabio
authors.affiliation: Neonatology Unit, "A. Perrino" Hospital - ASL, 72100 Brindisi, Italy.
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Quartulli
authors.affiliation: Pediatric Department, Medical School University "La Sapienza" Rome, Azienda Ospedaliera Policlinico Umberto I, 00161 Rome, Italy.
authors.forename: Luigi
authors.initials: L
authors.lastname: Giannini
mesh_terms: D003696:Delivery Rooms / Q000458:organization & administration*; D019468:Disease Management; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D052577:Infant, Extremely Low Birth Weight; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000628:therapy*; D007558:Italy; D008297:Male; D012189:Retrospective Studies; D013997:Time Factors
keywords: Delivery room; Guidelines, infant, newborn; Premature; Resuscitation; Survey