Delivery room management of very low birth weight infants in Germany, Austria and Switzerland - a comparison of protocols

<p>Abstract</p> <p>Background</p> <p>Surveys from the USA, Australia and Spain have shown significant inter-institutional variation in delivery room (DR) management of very low birth weight infants (VLBWI, < 1500 g) at birth, despite regularly updated international guidelines.</p> <p>Objective</p> <p>To investigate protocols for DR management of VLBWI in Germany, Austria and Switzerland and to compare these with the 2005 ILCOR guidelines.</p> <p>Methods</p> <p>DR management protocols were surveyed in a prospective, questionnaire-based survey in 2008. Results were compared between countries and between academic and non-academic units. Protocols were compared to the 2005 ILCOR guidelines.</p> <p>Results</p> <p>In total, 190/249 units (76%) replied. Protocols for DR management existed in 94% of units. Statistically significant differences between countries were found regarding provision of 24 hr in house neonatal service; presence of a designated resuscitation area; devices for respiratory support; use of pressure-controlled manual ventilation devices; volume control by respirator; and dosage of Surfactant. There were no statistically significant differences regarding application and monitoring of supplementary oxygen, or targeted saturation levels, or for the use of sustained inflations. Comparison of academic and non-academic hospitals showed no significant differences, apart from the targeted saturation levels (SpO₂) at 10 min. of life. Comparison with ILCOR guidelines showed good adherence to the 2005 recommendations.</p> <p>Summary</p> <p>Delivery room management in German, Austrian and Swiss neonatal units was commonly based on written protocols. Only minor differences were found regarding the DR setup, devices used and the targeted ranges for SpO₂and FiO₂. DR management was in good accordance with 2005 ILCOR guidelines, some units already incorporated evidence beyond the ILCOR statement into their routine practice.</p

Delivery room management of very low birth weight infants in Germany, Austria and Switzerland--a comparison of protocols

Surveys from the USA, Australia and Spain have shown significant inter-institutional variation in delivery room (DR) management of very low birth weight infants (VLBWI, <1500g) at birth, despite regularly updated international guidelines

Plastic-reconstructive surgery from the point of view of oral- and maxillofacial surgery: status quo

The prior aim of facial plastic-reconstructive surgery was and will be the adequate restitution of appearance and function so that patients with trauma- or tumorassociated defects as well as congenital malformations can be successfully rehabilitated. Nowadays, three major techniques are used to achieve this goal: local flaps, pedicled flaps and microsurgical flaps. This overview article describes in detail the three major techniques of facial plastic reconstructive surgery from past to present and gives an outlook on upcoming new techniques like the virtual planning of reconstructive measures.Die plastisch-rekonstruktive Chirurgie im Bereich des Gesichtes hatte schon immer den Anforderungen der Wiederherstellung von Aussehen und Funktion zu genügen, damit Patienten mit tumor- oder traumabedingten Defekten oder angeborenen Fehlbildungen posttherapeutisch erfolgreich rehabilitiert werden können. Um dieses Ziel zu erreichen, kommen derzeit drei wesentliche Techniken zum Einsatz: lokale Nahlappenplastiken, gestielte regionale Lappen und mikrochirurgische Transplantate. Die vorliegende Übersichtsarbeit beschreibt diese drei Haupttechniken der plastisch-rekonstruktiven Chirurgie des Gesichtes und gibt einen Ausblick auf neuartige Technologien wie der virtuellen Planung von rekonstruktiven Eingriffen