Universität zu Köln

Mehler, Katrin, Grimme, Judith, Abele, Julia, Huenseler, Christoph, Roth, Bernhard and Kribs, Angela (2012). Outcome of extremely low gestational age newborns after introduction of a revised protocol to assist preterm infants in their transition to extrauterine life. Acta Paediatr., 101 (12). S. 1232 - 1240. HOBOKEN: WILEY-BLACKWELL. ISSN 0803-5253

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Abstract

Aim: To evaluate the outcome of a cohort of extremely low gestational age newborn infants (ELGAN) below 26-week gestation who were treated following a revised, gentle delivery room protocol to assist them in the transition and adaptation to extrauterine life. Methods: A cohort of infants with a gestational age (GA) below 26 weeks (study group; n = 164) was treated according to a revised delivery room protocol. The protocol included an optimized prenatal management, strict use of continuous positive airway pressure (CPAP), avoiding mechanical ventilation and early administration of surfactant without intubation. The parameters management of respiratory distress syndrome, survival, neonatal morbidity and neurodevelopmental outcome were compared with a historical control group (n = 44). Results: Seventy-four per cent of the study group infants were initially treated with CPAP and surfactant administration without intubation. In comparison with the control group, significantly less children were intubated in the delivery room (24% vs. 41%) and needed mechanical ventilation (51% vs. 72%; both p < 0.05). Furthermore, compared with the historical control overall mortality (20% vs. 39%), rate of bronchopulmonary dysplasia (18% vs. 37%) and IVH > II degrees(10% vs. 33%) in survivors were significantly lower during the observational period (all p < 0.05). Neurodevelopmental outcome was normal in 70% of examined study group infants. Conclusions: A revised delivery room management protocol was applied safely to infants with a GA below 26 completed weeks with improved rates of survival and morbidity.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Mehler, Katrin UNSPECIFIED UNSPECIFIED UNSPECIFIED Grimme, Judith UNSPECIFIED UNSPECIFIED UNSPECIFIED Abele, Julia UNSPECIFIED UNSPECIFIED UNSPECIFIED Huenseler, Christoph UNSPECIFIED UNSPECIFIED UNSPECIFIED Roth, Bernhard UNSPECIFIED UNSPECIFIED UNSPECIFIED Kribs, Angela UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-477616
DOI:	10.1111/apa.12015
Journal or Publication Title:	Acta Paediatr.
Volume:	101
Number:	12
Page Range:	S. 1232 - 1240
Date:	2012
Publisher:	WILEY-BLACKWELL
Place of Publication:	HOBOKEN
ISSN:	0803-5253
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language BIRTH-WEIGHT INFANTS; POSITIVE AIRWAY PRESSURE; MECHANICAL VENTILATION; DELIVERY ROOM; SCHOOL-AGE; SURFACTANT; RESUSCITATION; MANAGEMENT; SURVIVAL; MINUTES Multiple languages Pediatrics Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/47761