Resuscitation of 22 week infants. What to think - how to act?

I guess many of you have read the interesting article in NEJM about Between-Hospital Variation in Treatment and Outcomes in Extremely Preterm Infants , and the great editorial by Neil Marlow on the Elephant in the Delivery Room.

In short, the research article showed that NICUs (in the US) being more pro-active in resuscitating 22week-infants had a greater survival and better outcomes than those NICUs that were more restrictive to act after deliveries at 22 (completed) weeks. However, even in "active" NICUs mortality was 77% at 22 weeks, as compared to 95% in "passive NICUs. And survival without major impairment was 15% and 3% in active and passive NICUs, respectively.

In Sweden, we currently have no national consensus on how to approach infants born at 22 weeks, "active" and "passive" strategies are both being promoted in different regions. And, as gestational age is also a non-exact figure, there is also a recent debate whether infants "around 22 weeks" (typically late 21 weekers) should be resuscitated, as those infants "true" gestational age could be ≥22 weeks.

Have the NEJM-paper above resulted in revisions of local/regional/national guidelines? Do you have ongoing ethical discussions about the limit of viability? To what degree is this discussion run by the NICU community, and how much are parental organisations and other laymen contexts involved?

It would be great to hear about the discussions within other countries with different levels of resources. What is considered the "actual" gestational week that is the limit of viability is not so much the focus of my thoughts, but rather the principal discussions behind decision-making.