{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,19]],"date-time":"2025-10-19T14:56:31Z","timestamp":1760885791296,"version":"3.41.2"},"reference-count":13,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2021,4,29]],"date-time":"2021-04-29T00:00:00Z","timestamp":1619654400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:p><jats:bold>Objective:<\/jats:bold> The aim of the study is to describe a delivery room intensive care unit (DRICU) model and evaluate its effectiveness in preventing morbidity and mortality in high-risk newborns.<\/jats:p><jats:p><jats:bold>Design:<\/jats:bold> This retrospective case series includes all DRICU procedures performed from 2016 to 2020.<\/jats:p><jats:p><jats:bold>Setting:<\/jats:bold> Gaslini Children's Hospital is a major pediatric tertiary care center where high-risk pregnancies are centralized. The Neonatal and Pediatric Intensive Care Unit admits every year about 100 high-risk newborns.<\/jats:p><jats:p><jats:bold>Patients:<\/jats:bold> The selected patients are newborns at risk of critical conditions immediately after birth for respiratory or cardiovascular congenital disorders.<\/jats:p><jats:p><jats:bold>Interventions:<\/jats:bold> The perinatal plan is defined by the multidisciplinary team of Fetal and Perinatal Medicine. The DRICU procedure provides highly specialized care through a protocol that includes logistics, personnel, equipment, and clinical pathways.<\/jats:p><jats:p><jats:bold>Main Outcome Measures:<\/jats:bold> The primary outcome is the prevention of acute complications and mortality in the delivery room and early neonatal period.<\/jats:p><jats:p><jats:bold>Results:<\/jats:bold> From 2016 to 2020, 40 DRICU procedures were performed. The main prenatal diagnoses included congenital heart disease with a high risk of life-threatening events immediately after birth (38%), congenital diaphragmatic hernia (35%), and fetal hydrops\/hydrothorax (23%). Mean gestational age was 35.9 weeks (range: 31\u201339), and mean birth weight was 2,740 grams (range: 1,480\u20133,920). DRICU assistance completed in all patients by neonatal intensivists included tracheal intubation and arterial and central venous cannulation; complex procedures such as ex-utero intrapartum technique and extracorporeal membrane oxygenation cannulation are described. No deaths nor severe acute complications occurred in the delivery room or in the immediate postnatal period.<\/jats:p><jats:p><jats:bold>Conclusions:<\/jats:bold> The outcome in critical newborns is potentially affected by planned assistance strategies and specialized competencies through the implementation of a DRICU protocol.<\/jats:p>","DOI":"10.3389\/fped.2021.647690","type":"journal-article","created":{"date-parts":[[2021,4,29]],"date-time":"2021-04-29T05:28:38Z","timestamp":1619674118000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Delivery Room Intensive Care Unit: 5 Years' Experience in Assistance of High-Risk Newborns at a Referral 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