TY - JOUR T1 - Fantoms JF - Archives of Disease in Childhood - Fetal and Neonatal Edition JO - Arch Dis Child Fetal Neonatal Ed SP - 571 LP - 571 DO - 10.1136/archdischild-2022-324971 VL - 107 IS - 6 AU - Ben J Stenson Y1 - 2022/11/01 UR - http://fn.bmj.com/content/107/6/571.abstract N2 - Brett Manley and colleagues report data from tertiary NICUs in the Australia and New Zealand Neonatal Network for the years 2010–2018. 14 656 inborn term (>37 weeks gestation) infants were admitted to 21 NICUs from 2010 to 2018. Non-invasive respiratory support use (largely CPAP) increased on average by 8.7% per year so that the use almost doubled over the period from 10.8 to 20.8 per thousand live births. Use increased in 19/21 units and decreased in none. Surfactant use increased, pneumothoraces increased. There was no change in need for ventilation or risk of mortality. In 2018, there was a more than fourfold range in non-invasive respiratory support rates per 1000 inborn livebirths in the 21 NICUs that were examined, from 9.7/1000 to 40.9/1000. These temporal changes and such variation in treatment usage cannot reflect differences in disease severity and are not driven by published evidence of benefit gathered in this patient group. The authors discuss possible drivers for their findings, including extrapolation of evidence from less mature infants, widespread use of devices that deliver PEEP during stabilisation and transfer to the neonatal … ER -