Survey of noninvasive respiratory support practices in Canadian neonatal intensive care units. (25th November 2016)

• Record Type: Journal Article
• Authors: Mukerji, Amit; Shah, Prakesh S.; Shivananda, Sandesh; Yee, Wendy; Read, Brooke; Minski, John; Alvaro, Ruben; Fusch, Christoph
• Other Names: Harrison Adele investigator.; Synnes Anne investigator.; Ting Joseph investigator.; Cieslak Zenon investigator.; Sherlock Rebecca investigator.; Aziz Khalid investigator.; Toye Jennifer investigator.; Fajardo Carlos investigator.; Kalapesi Zarin investigator.; Sankaran Koravangattu investigator.; Daspal Sibasis investigator.; Seshia Mary investigator.; Silva Orlando investigator.; Nwaesei Chuks investigator.; Lee Kyong‐Soon investigator.; Dunn Michael investigator.; Lemyre Brigitte investigator.; Dow Kimberly investigator.; Pelausa Ermelinda investigator.; Barrington Keith investigator.; Drolet Christine investigator.; Piedboeuf Bruno investigator.; Claveau Martine investigator.; Faucher Daniel investigator.; Bertelle Valerie investigator.; Masse Edith investigator.; Canning Roderick investigator.; Makary Hala investigator.; Ojah Cecil investigator.; Monterrosa Luis investigator.; Deshpandey Akhil investigator.; Afifi Jehier investigator.; Kajetanowicz Andrzej investigator.; Lee Shoo K. investigator.;
• Is Part Of: Acta pædiatrica. Volume 106:Number 3(2017)
• Page Start: 387
• Page End: 393
• Publication Date: 2016-11-25
• Subjects: Bronchopulmonary dysplasia -- Noninvasive ventilation -- Practice variation -- Ventilator‐induced lung injury; Pediatrics -- Periodicals; Pediatrics; 618.92
• DOI: 10.1111/apa.13644
• Languages: English
• ISSNs: 0803-5253

Abstract

Abstract: 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.