TY - JOUR
T1 - Survey of noninvasive respiratory support practices in Canadian neonatal intensive care units
AU - the Canadian Neonatal Network Investigators
AU - Mukerji, Amit
AU - Shah, Prakesh S.
AU - Shivananda, Sandesh
AU - Yee, Wendy
AU - Read, Brooke
AU - Minski, John
AU - Alvaro, Ruben
AU - Fusch, Christoph
AU - Harrison, Adele
AU - Synnes, Anne
AU - Ting, Joseph
AU - Cieslak, Zenon
AU - Sherlock, Rebecca
AU - Aziz, Khalid
AU - Toye, Jennifer
AU - Fajardo, Carlos
AU - Kalapesi, Zarin
AU - Sankaran, Koravangattu
AU - Daspal, Sibasis
AU - Seshia, Mary
AU - Silva, Orlando
AU - Nwaesei, Chuks
AU - Lee, Kyong Soon
AU - Dunn, Michael
AU - Lemyre, Brigitte
AU - Dow, Kimberly
AU - Pelausa, Ermelinda
AU - Barrington, Keith
AU - Drolet, Christine
AU - Piedboeuf, Bruno
AU - Claveau, Martine
AU - Faucher, Daniel
AU - Bertelle, Valerie
AU - Masse, Edith
AU - Canning, Roderick
AU - Makary, Hala
AU - Ojah, Cecil
AU - Monterrosa, Luis
AU - Deshpandey, Akhil
AU - Afifi, Jehier
AU - Kajetanowicz, Andrzej
AU - Lee, Shoo K.
N1 - Funding Information:
Although no specific research funding was received for this study, the Canadian Neonatal Network Coordinating Centre is supported by the Maternal-Infant Care (MiCare) Research Centre at Mount Sinai Hospital, Toronto, ON, Canada. MiCare is funded by the Canadian Institutes of Health Research (CIHR) (FRN87518). Dr Shah holds an Applied Research Chair in Reproductive and Child Health Services and Policy Research awarded by CIHR (APR-126340). The funding agencies had no role in the design and conduct of the study; collection, management, analysis and interpretation of the data; preparation, review or approval of the manuscript; and decision to submit the manuscript for publication.
Publisher Copyright:
©2016 Foundation Acta Pædiatrica. Published by John Wiley & Sons Ltd
PY - 2017/3/1
Y1 - 2017/3/1
N2 - Aim: To evaluate practice variation with respect to noninvasive respiratory support (NRS) use across Canadian neonatal intensive care units (NICUs). Methods: A web-based survey was sent to all site investigators of the 30 level 3 NICUs participating in the Canadian Neonatal Network. The survey inquired about the use of five commonly described NRS modes. In addition, the presence and adherence to local guidelines were ascertained. Descriptive analyses were performed to identify variations in practice. Results: In total, 28 (93%) of the 30 tertiary NICUs responded to the survey. Continuous positive airway pressure (CPAP) was employed universally (100%). High-flow nasal cannula (HFNC) was used in 89% of NICUs, biphasic CPAP in 79% and nasal intermittent positive pressure ventilation (NIPPV) in 54%, and nasal high-frequency ventilation was used in 18% of units. Only 61% of all NRS use was guided by local policies, with the lowest being for HFNC (36%). There was a wide range of settings employed and interfaces used for all NRS modes. Conclusion: There are significant practice variations in NRS use across Canadian NICUs. Further research is needed to evaluate the significance in relation to pulmonary outcomes to determine optimal NRS strategies.
AB - Aim: To evaluate practice variation with respect to noninvasive respiratory support (NRS) use across Canadian neonatal intensive care units (NICUs). Methods: A web-based survey was sent to all site investigators of the 30 level 3 NICUs participating in the Canadian Neonatal Network. The survey inquired about the use of five commonly described NRS modes. In addition, the presence and adherence to local guidelines were ascertained. Descriptive analyses were performed to identify variations in practice. Results: In total, 28 (93%) of the 30 tertiary NICUs responded to the survey. Continuous positive airway pressure (CPAP) was employed universally (100%). High-flow nasal cannula (HFNC) was used in 89% of NICUs, biphasic CPAP in 79% and nasal intermittent positive pressure ventilation (NIPPV) in 54%, and nasal high-frequency ventilation was used in 18% of units. Only 61% of all NRS use was guided by local policies, with the lowest being for HFNC (36%). There was a wide range of settings employed and interfaces used for all NRS modes. Conclusion: There are significant practice variations in NRS use across Canadian NICUs. Further research is needed to evaluate the significance in relation to pulmonary outcomes to determine optimal NRS strategies.
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U2 - 10.1111/apa.13644
DO - 10.1111/apa.13644
M3 - Article
C2 - 27783410
AN - SCOPUS:85005765107
SN - 0803-5253
VL - 106
SP - 387
EP - 393
JO - Acta Paediatrica, International Journal of Paediatrics
JF - Acta Paediatrica, International Journal of Paediatrics
IS - 3
ER -