PT - JOURNAL ARTICLE AU - Dean Hayden AU - Maria Esterlita Villanueva-Uy AU - Maria Katrina Mendoza AU - Dominic Wilkinson TI - Resuscitation of preterm infants in the Philippines: a national survey of resources and practice AID - 10.1136/archdischild-2019-316951 DP - 2020 Mar 01 TA - Archives of Disease in Childhood - Fetal and Neonatal Edition PG - 209--214 VI - 105 IP - 2 4099 - http://fn.bmj.com/content/105/2/209.short 4100 - http://fn.bmj.com/content/105/2/209.full SO - Arch Dis Child Fetal Neonatal Ed2020 Mar 01; 105 AB - Objective There is a high incidence of preterm birth in low-income and middle-income countries where healthcare resources are often limited and may influence decision making. We aimed to explore the interplay between resource limitations and resuscitation practices for extremely preterm infants (EPIs) in neonatal intensive care units (NICUs) across the Philippines.Methods We conducted a national survey of NICUs in the Philippines. Institutions were classified according to sector (private/public), region and level. Respondents were asked about unit capacity, availability of ventilators and surfactant, resuscitation practices and estimated survival rates for EPIs of different gestational ages.Results Respondents from 103/228 hospitals completed the survey (response rate 45%). Public hospitals reported more commonly experiencing shortages of ventilators than private hospitals (85%vs23%, p<0.001). Surfactant was more likely to be available in city hospitals than regional/district hospitals (p<0.05) and in hospitals classified as Level III/IV than I/II (p<0.05). The financial capacity of parents was a major factor influencing treatment options. Survival rates for EPIs were estimated to be higher in private than public institutions. Resuscitation practice varied; active treatment was generally considered optional for EPIs from 25 weeks’ gestation and usually provided after 27–28 weeks’ gestation.Conclusion Our survey revealed considerable disparities in NICU resource availability between different types of hospitals in the Philippines. Variation was observed between hospitals as to when resuscitation would be provided for EPIs. National guidelines may generate greater consistency of care yet would need to reflect the variable context for decisions in the Philippines.