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Background <p>Our survey aimed to compare information on respiratory care in Neonatal Intensive Care Units (NICUs) in Italy and in the European and Mediterranean region.</p> Methods <p>Cross-sectional electronic survey. An 89-item questionnaire focusing on the current modes, devices, and strategies employed in neonatal units in the domain of respiratory care was sent to directors/heads of 528 NICUs.</p> Results <p>The response rate was 75% (397/528 units). The median number of NICU beds and the admission rate per unit/year of preterm infants &lt; 1500&#xa0;g was significantly lower in Italy compared with Europe (<i>p</i> &lt; 0.001). In most Italian Delivery Rooms (DR) full resuscitation is given from 22 to 23 weeks gestational age, while 21.0% of the European units initiate from 24 weeks. Initial FiO<sub>2</sub> is set as per American Academy of Pediatrics guidelines in 81.1% of Italian units compared to 30.9% of the European ones (<i>p</i> &lt; 0.001). DR surfactant is less often given through Less-Invasive-Surfactant-Administration (LISA) in Italy (53.4% vs. 76.2% of units, <i>p</i> &lt; 0.03). Volume-targeted, synchronized intermittent positive-pressure ventilation (IPPV) is the preferred invasive mechanical ventilation (MV) mode to treat acute RDS across the surveyed units, however 22.9% % of Italian centers vs. 6.8% of the European ones use HFOV as first choice (<i>p</i> &lt; 0.001). During HFOV, 78% of Italian NICUs set mean airway pressure (MAP) following a lung recruitment procedure compared to 41% of the centers in Europe (<i>p</i> &lt; 0.001). In the NICUs, most of the non-invasive (NIV) modes used are nasal CPAP and nasal IPPV. For infants on NIV, LISA strategy is used in 25.6% of Italian vs. 60.0% of European units (<i>p</i> &lt; 0.001). 70% of surveyed units use a brand caffeine. Inhaled steroids are used in 42.3% of Italian vs. 65.4% of European NICUs (<i>p</i> &lt; 0.001).</p> Conclusions <p>respiratory support strategies among the surveyed Italian and European NICUs are quite dissimilar in some areas, particularly where high-quality evidence is lacking. We believe that hese data will allow stakeholders to make comparisons and to identify opportunities for improvement.</p>

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Comparing Italian versus European strategies and technologies for respiratory care in NICU: results of a survey of the Union of European Neonatal and Perinatal Societies (UENPS) and the Italian Society of Neonatology (SIN)

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  • 发表日期：

    2025年3月26日

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  • Camilla Gizzi,
  • Flavia Petrillo,
  • Maria Luisa Ventura,
  • Luigi Gagliardi,
  • Daniele Trevisanuto,
  • Gianluca Lista,
  • Raffaele Dellacà,
  • Artur Beke,
  • Giuseppe Buonocore,
  • Antonia Charitou,
  • Manuela Cucerea,
  • Boris Filipović-Grčić,
  • Nelly Georgieva Jeckova,
  • Esin Koç,
  • Joana Saldanha,
  • Manuel Sanchez-Luna,
  • Dalia Stoniene,
  • Heili Varendi,
  • Giulia Vertecchi,
  • Luigi Orfeo,
  • Fabio Mosca,
  • Corrado Moretti

摘要

Background

Our survey aimed to compare information on respiratory care in Neonatal Intensive Care Units (NICUs) in Italy and in the European and Mediterranean region.

Methods

Cross-sectional electronic survey. An 89-item questionnaire focusing on the current modes, devices, and strategies employed in neonatal units in the domain of respiratory care was sent to directors/heads of 528 NICUs.

Results

The response rate was 75% (397/528 units). The median number of NICU beds and the admission rate per unit/year of preterm infants < 1500 g was significantly lower in Italy compared with Europe (p < 0.001). In most Italian Delivery Rooms (DR) full resuscitation is given from 22 to 23 weeks gestational age, while 21.0% of the European units initiate from 24 weeks. Initial FiO2 is set as per American Academy of Pediatrics guidelines in 81.1% of Italian units compared to 30.9% of the European ones (p < 0.001). DR surfactant is less often given through Less-Invasive-Surfactant-Administration (LISA) in Italy (53.4% vs. 76.2% of units, p < 0.03). Volume-targeted, synchronized intermittent positive-pressure ventilation (IPPV) is the preferred invasive mechanical ventilation (MV) mode to treat acute RDS across the surveyed units, however 22.9% % of Italian centers vs. 6.8% of the European ones use HFOV as first choice (p < 0.001). During HFOV, 78% of Italian NICUs set mean airway pressure (MAP) following a lung recruitment procedure compared to 41% of the centers in Europe (p < 0.001). In the NICUs, most of the non-invasive (NIV) modes used are nasal CPAP and nasal IPPV. For infants on NIV, LISA strategy is used in 25.6% of Italian vs. 60.0% of European units (p < 0.001). 70% of surveyed units use a brand caffeine. Inhaled steroids are used in 42.3% of Italian vs. 65.4% of European NICUs (p < 0.001).

Conclusions

respiratory support strategies among the surveyed Italian and European NICUs are quite dissimilar in some areas, particularly where high-quality evidence is lacking. We believe that hese data will allow stakeholders to make comparisons and to identify opportunities for improvement.