Impact of updated European Consensus Guidelines on the management of neonatal respiratory distress syndrome on clinical outcome of preterm infants.

Abstract

European Consensus Guidelines (ECG) on the management of respiratory distress syndrome (RDS) have been developed and updated twice since 2007 reflecting changes in practice as new evidence emerges. The aim of this study was to evaluate the progress in clinical outcome of babies after the implementation of the updated ECG in 2010. Forty-eight neonates born in 2002-2003 (Group 02/03; n = 15) and in 2012-2013 (Group 12/13; n = 33) at gestational age of 26.2 ± 1.7 weeks were included into this retrospective study. Resuscitation procedures, ventilation support, and postnatal administration of surfactant were assessed. In Group 12/13, compared with Group 02/03, there was a higher rate of maternal corticosteroid prophylactic treatment (33 % vs. 0 %, p < 0.001), more children received primary nasal continuous positive airway pressure (nCPAP) (54.5 % vs. 20 %, p < 0.01) and repeated doses of surfactant (33 % vs. 0 %, p < 0.001), and had a reduced rate of mortality, bronchopulmonary dysplasia, and necrotizing enterocolitis. We conclude that the management of extremely preterm newborns improved considerably over the decade resulting in a significant reduction of mortality and morbidity.