Proactive neonatal treatment at 22 weeks of gestation: a systematic review and meta-analysis

Backes, Carl H.; Rivera, Brian K.; Pavlek, Leanne; Beer, Lindsey J.; Ball, Molly K.; Zettler, Eli T.; Smith, Charles V.; Bridge, Jeffrey A.; Bell, Edward F.; Frey, Heather A.

doi:10.1016/j.ajog.2020.07.051

Cited by 73 publications

(45 citation statements)

References 68 publications

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“…Survival rates of extremely preterm neonates continue to improve, including for those born at 22-23 weeks of gestational age. [4][5][6][7][8] However, rates of respiratory morbidity and bronchopulmonary dysplasia (BPD) remain unacceptably high, especially among these most immature, highest risk neonates (<28 weeks of gestation, and in particular <25 weeks of gestation). 9 Thus, choosing the best care options is one of the central challenges to be met.With continuous positive airway pressure (CPAP) and surfactant replacement therapy, present-day neonatologists are equipped with 2 powerful tools.…”

mentioning

confidence: 99%

Noninvasive Ventilation and Exogenous Surfactant in Times of Ever Decreasing Gestational Age: How Do We Make the Most of These Tools?

Wright

Glaser

Speer

et al. 2022

The Journal of Pediatrics

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mentioning

confidence: 99%

Noninvasive Ventilation and Exogenous Surfactant in Times of Ever Decreasing Gestational Age: How Do We Make the Most of These Tools?

Wright

Glaser

Speer

et al. 2022

The Journal of Pediatrics

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“…The trials forming the basis for this knowledge are, however, dated and included only small numbers or even no infants with 22-24 weeks of GA. 7 The role of ANCS in these infants therefore rests on observational evidence which to date, suggest similar or even more pronounced benefits of ANCS at extremely preterm birth than at later GAs. 8 [9,10,12] 11 12 ANCS for extremely preterm births have been recommended in several countries. [13] , 14 Still, not all infants are treated, Fig.…”

Section: Antenatal Corticosteroidsmentioning

confidence: 99%

Respiratory support of infants born at 22–24 weeks of gestational age

Norman

Jónsson

Wallström

et al. 2022

Seminars in Fetal and Neonatal Medicine

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“…1 Many neonatal intensive care units (NICUs) are now providing active care to infants as young as 22 weeks gestation. 2 One of the most critical periods of life is the “golden hour”, this refers to the first hour of life following the birth of an EP infant. During this important period, evidence-based initial stabilisation practices including maintenance of normothermia are performed.…”

Section: Introductionmentioning

confidence: 99%

Thermoregulation and golden hour practices in extremely preterm infants: an international survey

et al. 2022

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Background Are thermoregulation and golden hour practices in extremely preterm (EP) infants comparable across the world? This study aims to describe these practices for EP infants based on the neonatal intensive care unit’s (NICUs) geographic region, country’s income status and the lowest gestational age (GA) of infants resuscitated. Methods The Director of each NICU was requested to complete the e-questionnaire between February 2019 and August 2021. Results We received 848 responses, from all geographic regions and resource settings. Variations in most thermoregulation and golden hour practices were observed. Using a polyethylene plastic wrap, commencing humidity within 60 min of admission, and having local protocols were the most consistent practices (>75%). The odds for the following practices differed in NICUs resuscitating infants from 22 to 23 weeks GA compared to those resuscitating from 24 to 25 weeks: respiratory support during resuscitation and transport, use of polyethylene plastic wrap and servo-control mode, commencing ambient humidity >80% and presence of local protocols. Conclusion Evidence-based practices on thermoregulation and golden hour stabilisation differed based on the unit’s region, country’s income status and the lowest GA of infants resuscitated. Future efforts should address reducing variation in practice and aligning practices with international guidelines. Impact A wide variation in thermoregulation and golden hour practices exists depending on the income status, geographic region and lowest gestation age of infants resuscitated. Using a polyethylene plastic wrap, commencing humidity within 60 min of admission and having local protocols were the most consistent practices. This study provides a comprehensive description of thermoregulation and golden hour practices to allow a global comparison in the delivery of best evidence-based practice. The findings of this survey highlight a need for reducing variation in practice and aligning practices with international guidelines for a comparable health care delivery.

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Proactive neonatal treatment at 22 weeks of gestation: a systematic review and meta-analysis

Cited by 73 publications

References 68 publications

Noninvasive Ventilation and Exogenous Surfactant in Times of Ever Decreasing Gestational Age: How Do We Make the Most of These Tools?

Noninvasive Ventilation and Exogenous Surfactant in Times of Ever Decreasing Gestational Age: How Do We Make the Most of These Tools?

Respiratory support of infants born at 22–24 weeks of gestational age

Thermoregulation and golden hour practices in extremely preterm infants: an international survey

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