(1) Background: Our survey aimed to gather information on respiratory care in Neonatal
Intensive Care Units (NICUs) in the European and Mediterranean region. (2) Methods:
Cross-sectional electronic survey. An 89-item questionnaire focusing on the current
modes, devices, and strategies employed in neonatal units in the domain of respiratory
care was sent to directors/heads of 528 NICUs. The adherence to the "European consensus
guidelines on the management of respiratory distress syndrome" was assessed for comparison.
(3) Results: The response rate was 75% (397/528 units). In most Delivery Rooms (DRs),
full resuscitation is given from 22 to 23 weeks gestational age. A T-piece device
with facial masks or short binasal prongs are commonly used for respiratory stabilization.
Initial FiO2 is set as per guidelines. Most units use heated humidified gases to prevent
heat loss. SpO2 and ECG monitoring are largely performed. Surfactant in the DR is
preferentially given through Intubation-Surfactant-Extubation (INSURE) or Less-Invasive-Surfactant-Administration
(LISA) techniques. DR caffeine is widespread. In the NICUs, most of the non-invasive
modes used are nasal CPAP and nasal intermittent positive-pressure ventilation. Volume-targeted,
synchronized intermittent positive-pressure ventilation is the preferred invasive
mode to treat acute respiratory distress. Pulmonary recruitment maneuvers are common
approaches. During NICU stay, surfactant administration is primarily guided by FiO2
and SpO2/FiO2 ratio, and it is mostly performed through LISA or INSURE. Steroids are
used to facilitate extubation and prevent bronchopulmonary dysplasia. (4) Conclusions:
Overall, clinical practices are in line with the 2022 European Guidelines, but there
are some divergences. These data will allow stakeholders to make comparisons and to
identify opportunities for improvement.
