USE OF INTRAVENOUS BICARBONATE IN ASPHYCTIC NEONATES IN EUROPE: DIFFERENCES OF APPROACH BETWEEN COUNTRIES

Objective The use of intravenous bicarbonate (IB) in severe asphyxia has been a matter of controversy. Physiological approach does not support it, but clinical practice not always follows the scientific path. Our aim was to evaluate the use of IB in the most relevant NICU’s in Europe. Methods Prospective survey using a questionnaire administered by email to neonatologist in Europe. The introduction was followed by demographic questions and then by a clinical case of asphyxia in a term newborn. The first question was: Is the IB indicated? Then a choice among additional measures was presented. Statistics: descriptive and Chi square. Results 259 neonatologist from 17 countries participated. The use of IB differed significantly between countries (see figure) although there were no significant differences in the selection of additional measures, or between those in favor or against the use of IB. Conclusions Although no scientific evidence has proven the benefit of using IB in the resuscitation of asphyxiated neonates, 40% of neonatologist in Europe are using it. However, there are significant differences between countries. There is a consensus in the additional measures to be taken. More studies in this regard are needed to establish evidence-based and generalized protocols.