Ashley F. Victor, Oregon Health & Science University School of Medicine, PORTLAND, OR, United States; Angela Douglas, Doernbecher Children's Hospital at Oregon Health & Science University, Portland, OR, United States; Catherine G. Caruso, Oregon Health and Science University, Portland, OR, United States; Dmitry Dukhovny, Doernbecher Children's Hospital at Oregon Health & Science University, Lake Oswego, OR, United States
MSIII Oregon Health & Science University School of Medicine PORTLAND, Oregon, United States
Background: Neonatal resuscitation is a required skill for pediatric residents to attain, and respiratory interventions such as bag-mask ventilation and intubation are critical steps for successful resuscitation. Development of these skills depend on the frequency of encountering deliveries requiring resuscitation. There is limited data on incidence of such opportunities, or to what degree prenatally known risk factors may be associated with need for interventions. Determination of current rates of advanced neonatal resuscitation and the impact of different maternal and infant characteristics are essential for residency programs to create realistic goals for learner exposure and skill acquisition and to efficiently structure clinical experiences to achieve those goals.
Objective: To quantify and characterize resuscitation interventions required at birth at a single quaternary center over the course of an academic year and identify any maternal/infant characteristics that may be associated with the need for resuscitation.
Design/Methods: Retrospective chart review was completed to identify all live births 6/1/2020-5/31/2021 at a single academic center in Portland, OR. Basic maternal, delivery, and infant data were collected. Delivery room interventions assessed included continuous positive airway pressure (CPAP), positive pressure ventilation (PPV), and intubation. Relative risk (RR) and 95% confidence interval (CI) were calculated for several potential risk factors, comparing patients with that risk factor to those without.
Results: A total of 2,201 infants born to 2,143 mothers were included, 95% were singletons. The mean maternal age was 31.3 years (SD=5.8), 74.9% were Caucasian and 16.3% identified as Hispanic. Infants were born at a mean of 38 weeks (range 24-42) and birthweight 3.2kg (range 0.52-6.5 kg). Of all births, 16.4% required some form of respiratory intervention (13.1% required CPAP, 8.7% required PPV, and 2.2% required intubation). Factors that significantly increased risk for resuscitation include lower gestational age, lower birth weight, multiple gestation, c-section delivery, and maternal fentanyl or magnesium exposure proximate to delivery (Table).Conclusion(s): There are limited numbers of real-life learning opportunities for neonatal resuscitation skills. Academic centers that train learners in neonatal resuscitation can use this study as a template to evaluate and prioritize available learning opportunities and adjust educational programming as needed to ensure trainees achieve competence in neonatal resuscitation. Ashley Victor CVVictor, A CV.pdf
