Efficiency of implementation of Local guideline of preterm newborns stabilization in delivery room, which includes sustained inflation of lung by indications followed by CPAP

Material and methods. Cohort retrospective trial. 341 premature newborns, borne in V.I. Kulakov Obstetrics, Gynecology and Perinatology National Medical Research Center of Ministry of Healthсаre of the Russian Federation were included in the period from 2013 to 2015 yrs were included. Newborns were divided into 2 groups: before new protocol was implemented (2013 year - 116 newborns) and after (2014-2015 yrs - 225 newborns). Mechanical ventilation in delivery room and in 48 hours of life, surfactant therapy, IVH, BPD, pneumothorax, survival rates were compared and assessed between two groups.

Results. Mechanical ventilation requirement in delivery room and in NICU in first 48 hours of life was in two time less after new protocol was implemented OR [95% CI] 0.53 [0.29; 0.95], p=0.032, and 0.52 [0.28; 0.99], р=0.047 respectively. Severe IVH, BPD, pneumothorax incidents did not increased after new protocol was implemented: 2.2, 5.8, 2.7% vs 6.9, 3.4, 6% respectively. New protocol implementation was associated with increasing of survival rates from 89 to 96% р=0.021 and decreasing of PDA incidents from 44.8 to 16.9% р<0.0001.

Conclusion. The implementation of new protocol of stabilization of premature babies in delivery room, which includes sustained inflation approach followed by CPAP is associated with reduction of mechanical ventilation requirement, and does not affect adverse outcomes.