Of the 186 units providing data, 69 units (37%) commence stabilisation in air, 83 units (45%) in blended oxygen and 34 units (18%) in 100% oxygen. Tertiary units Doxorubicin clinical trial started stabilisation in air or blended gas more frequently than non-tertiary units (91% vs.

78%, P = 0.04) ( Fig. 2). Pulse oximetry to monitor heart rate or titrate oxygen delivery was used routinely in 30% units (n = 56). For 10 units (5%) this data was not provided. There was insufficient evidence of a difference in pulse oximetry between tertiary and non-tertiary units (79% vs. 66%, P = 0.12). Almost all neonatal units (190 of 192; 99%) use plastic wrapping to enhance thermoregulation in the DR and there was no statistical difference between use of plastic bag in tertiary and non-tertiary units (P = 0.477). Median gestation under what both tertiary and non-tertiary neonatal units used occlusive wrapping was 30 weeks). Deferred cord clamping (DCC) was reported as usual practice at 52 units (28%). There was marked variation in duration of DCC (30 s–3 min) with most common practice between 31 and 60 s. 4 units reported practicing cord milking. There was no significant difference in the percentage practicing DCC between tertiary and non-tertiary units (35% vs. 24%, P = 0.16). 119 units (63%) reported routine out of hours consultant attendance at very preterm birth and there was wide

variation between units under what gestation consultants routinely attend very preterm birth delivery. A higher proportion of tertiary units practiced routine consultant attendance GSK-3 signaling pathway at very preterm birth (82% vs. 55%, P = 0.0005). We found that some aspects of recommended stabilisation practice have penetrated well into current UK practice, such as use of occlusive plastic wrapping. The utilisation Carnitine dehydrogenase of other techniques, such as delivery room CPAP, delivery room pulse oximetry and provision of mixed ventilation gases has improved in a short time frame, although marked variation in practice persists [3]. Our data show that tertiary units appear to have adopted

recommended practices more quickly than other units. Our study has significant strengths – particularly its very high response rate, which means it is likely we are describing practices neonatal professionals intend to deploy one year after the revised ILCOR guidelines. However, our questionnaire approach precludes describing actual clinical practice. Meta-analysis of studies comparing outcome following resuscitation in air and oxygen demonstrated increased mortality in infants started in 100% oxygen.9 The ILCOR 2010 guidelines recommend starting resuscitation for term infants in air rather than 100% oxygen and administration of supplementary oxygen should be regulated by blending oxygen and air and the amount delivered to be guided by oximetry.