title: German experience in the management of ELGAN infants.
abstract: Of 680 000 infants born in Germany a year roughly 10% are preterm and 1% are very preterm. They are treated in around 150 level 1 perinatal centers and there are various credos how to best treat the ELGAN infant. However, many centers include the use of a sustained inflation for lung aeration in the standard protocol of delivery room care in Germany. As a result of the large studies on delivery room care, a trend for earlier or prophylactic surfactant in the most immature infants can be observed, however, surfactant is increasingly given in a new less invasive way called LISA. German randomized controlled trials on LISA , on permissive hypercapnia in the premature infants and a German initiated European trial on inhaled steroids have been completed and preliminary results are available. NIRS so far mostly is used for research reasons; however, the number of centers that monitor brain oxygenation for clinical reasons to guide hemodynamic management is increasing. A recent initiative was able to tremendously reduce the rate of IVH by prospective multidisciplinary surveillance.
authors.affiliation: Neonatology and Ped. Intensive Care, Center for Pediatrics, University of Freiburg, Germany. submission@actabiomedica.it.
authors.forename: Hans
authors.initials: H
authors.lastname: Fuchs
mesh_terms: D002985:Clinical Protocols; D005858:Germany; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D015931:Intensive Care, Neonatal; D018579:Patient Selection; D011663:Pulmonary Surfactants / Q000627:therapeutic use*; D012121:Respiration, Artificial; D012127:Respiratory Distress Syndrome, Newborn / Q000628:therapy*
chemical_list: D011663:Pulmonary Surfactants