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Moving from experience to evidence: changes in US Neonatal Resuscitation Program based on International Liaison Committee on Resuscitation Review

Journal of Perinatology volume 28, pages S35–S40 (2008)Cite this article

Abstract

The Neonatal Workgroup of the International Liaison Committee on Resuscitation recently made available their rigorous review of the scientific evidence base for selected neonatal resuscitation issues. The Neonatal Resuscitation Program guidelines have been recently revised based on that review and published as the Textbook of Neonatal Resuscitation, 5th edn. This review article highlights pertinent changes in recommendations, including revisions in: oxygen use; CO2 detectors for confirmation of intubation; management of the infant born through meconium-stained amniotic fluid; initial ventilation devices and strategies; thermal protection of very small preterm infants; medications, including doses and routes of delivery; postresuscitation therapies for consideration and ethical issues in initiation and discontinuation of resuscitation.

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References

  1. American Heart Association. J Am Heart Assoc 2005; 112: b1–b14. available at: http://www.circ.ahajournals.org/cgi/content/full/112/22_suppl/b1.

    Google Scholar 

  2. Short J . Textbook of Neonatal Resuscitation. 5th edn. American Academy of Pediatrics: Elk Grove Village, IL, 2006.

    Google Scholar 

  3. American Academy of Pediatrics. Neonatal Resuscitation Program: instructor update. American Heart Association 2006; 15: 2.

    Google Scholar 

  4. Perlman JM, Kattwinkel J . Delivery room resuscitation past, present, and the future. Clin Perinatology 2006; 33: 1.

    Article  Google Scholar 

  5. Tan A, Schulz A, O’Donnell CPF, Davis PG . Air versus oxygen for resuscitation of infants at birth (Cochrane review). John Wiley & Sons, Ltd: Chichester, UK, 2004.

    Google Scholar 

  6. Davis PG, Tan A, O’Donnel CPF, Schultz A . Resuscitation of newborn infants with 100% oxygen or air: a systematic review and meta-analysis. Lancet 2004; 364: 1329–1333.

    Article  Google Scholar 

  7. Gerstmann D, Berg R, Haskell R, Brower C, Wood K, Yoder B et al. Operational evaluation of pulse oximetry in NICU patients with arterial access. J Perinatol 2003; 23: 378–383.

    Article  Google Scholar 

  8. Harris AP, Sendak MJ, Donham RT . Changes in arterial oxygen saturation immediately after birth in the human neonate. J Pediatr 1986; 109: 117–119.

    Article  CAS  Google Scholar 

  9. House JT, Schultetus RR, Gravenstein N . Continuous neonatal evaluation in the delivery room by pulse oximetry. J Clin Monit 1987; 3: 96–100.

    Article  CAS  Google Scholar 

  10. Toth B, Becker A, Seelbach-Gobel B . Oxygen saturation in healthy newborn infants immediately after birth measured by pulse oximetry. Arch Gynecol Obstet 2002; 266: 105–107.

    Article  CAS  Google Scholar 

  11. Richmond S, Goldsmith JP . Air or 100% oxygen in neonatal resuscitation? Clin Perinatol 2006; 33: 11–28.

    Article  CAS  Google Scholar 

  12. Vain NE, Szyld EG, Prudent LM, Wiswell TE, Aguilar AM, Vivas NI et al. Oropharyngeal and nasopharyngeal suctioning of meconium-stained neonates before delivery of their shoulders: multicentre, randomized, controlled trial. Lancet 2004; 364: 597–602.

    Article  Google Scholar 

  13. Fraser WD, Hofmeyr J, Lede R, Faron G, Alexander S, Goffinet F et al. Amnioninfusion for the prevention of the meconium aspiration syndrome. N Engl J Med 2005; 353: 909–917.

    Article  CAS  Google Scholar 

  14. Velaphi S, Vidyasagar D . Intrapartum and postdelivery management of infants born to mothers with meconium-stained amniotic fluid: evidence-based recommendations. Clin Perinatol 2006; 33: 29–42.

    Article  Google Scholar 

  15. Costeloe K, Hennessy E, Gibson AT, Marlow N, Wilkinson AR . The EPICure Study. Outcomes to discharge from hospital for infants born at the threshold of viability. Pediatrics 2000; 106: 659–671.

    Article  CAS  Google Scholar 

  16. Vohra S, Frent G, Campbell V, Abbott M, Whyte R . Effect of polyethylene occlusive skin wrapping on heat loss in very low birth weight infants at delivery. J Pediatr 1999; 134: 547–551.

    Article  CAS  Google Scholar 

  17. Vohra S, Roberts RS, Zhang B, Janes M, Schmidt B . Heat loss prevention (HeLP) in the delivery room: a randomized controlled trial of polyethylene occlusive skin wrapping in very preterm infants. J Pediatr 2004; 145: 750–753.

    Article  Google Scholar 

  18. Lenclen R, Mazaani M, Jugie M, Couderc S, Hoenn E, Carbajal R et al. Utilisation d’un sac en polyèthylène: un moyen d’amèliorer l’environment thermique du prèmaturè en sale de naissance [use of polyethylene bag: a means of improving the thermal environment for premature babies in the delivery room]. Arch Pediatr 2002; 25: 304–308.

    Google Scholar 

  19. Knobel RB, Wimmer JE, Holbert D . Heat loss prevention for preterm infants in the delivery room. J Perinatol 2005; 25: 304–308.

    Article  Google Scholar 

  20. Bjorklund LJ, Hellstrom-Westas L . Reducing heat loss at birth in very preterm infants. J Pediatr 2000; 135: 739.

    Article  Google Scholar 

  21. Karsdon J, Stijnen T, Berger HM . The effect of a manometer on the mean airway pressure during hand ventilation, an in vitro study. Eur J Pediatr 1989; 148: 574–576.

    Article  CAS  Google Scholar 

  22. Hussey SG, Ryan CA, Murphy BP . Comparison of three manual ventilation devices using an intubated mannequin. Arch Dis Child Fetal Neonatal Ed 2004; 89: 490–493.

    Article  Google Scholar 

  23. Allwood AC, Madar RJ, Baumer JH, Readdy L, Wright D . Changes in resuscitation practice at birth. Arch Dis Child Fetal Neonatal Ed 2003; 88: 375–379.

    Article  Google Scholar 

  24. Hoskyns EW, Milner AD, Hopkin IE . A simple method of face mask resuscitation at birth. Arch Dis Child 1987; 62: 376–378.

    Article  CAS  Google Scholar 

  25. Milner AD, Vyas H, Hopkin IE . Efficacy of facemask resuscitation at birth. BMJ 1984; 61: 300–302.

    Google Scholar 

  26. Finer NN, Rich W, Craft A, Henderson C . Comparison of methods of bag and mask ventilation for neonatal resuscitation. Resuscitation 2001; 49: 299–305.

    Article  CAS  Google Scholar 

  27. Oddie S, Wyllie J, Scally A . Use of self-inflating bags for neonatal resuscitation. Resuscitation 2005; 67: 109–112.

    Article  Google Scholar 

  28. O’Donnell CP, Davis PG, Lau R, Dargaville PA, Doyle LW, Morley CJ . Neonatal resuscitation 2: an evaluation of manual ventilation devices and face masks. Arch Dis Child Fetal Nenatal Ed 2005; 90: F397–F400.

    Article  Google Scholar 

  29. Halamek LP, Morley C . Continuous positive airway pressure during neonatal resuscitation. Clin Perinatol 2006; 33: 83–98.

    Article  Google Scholar 

  30. Wyllie J, Carlo WA . The role of carbon dioxide detectors for confirmation of endotracheal tube position. Clin Perinatol 2006; 33: 111–119.

    Article  Google Scholar 

  31. Aziz HF, Martin JB, Moor JJ . The pediatric disposable end-tidal carbon dioxide detector role in endotracheal intubation in newborns. J Perinatol 1999; 19: 110–113.

    Article  CAS  Google Scholar 

  32. Roberts WA, Maniscalco WM, Cohen AR, Litman RS, Chhibber A . The use of capnography for recognition of esophageal intubation in the neonatal intensive care unit. Pediatr Pulmonol 1995; 19: 262–268.

    Article  CAS  Google Scholar 

  33. Repetto JE, Donohue PA-CPK, Baker SF, Kelly L, Nogee LM . Use of capnography in the delivery room for assessment of endotracheal tube placement. J Perinatol 2001; 21 (5): 284–287.

    Article  CAS  Google Scholar 

  34. Bhende MS, Thompson AE . Evaluation of an end-tidal CO2 detector during pediatric cardiopulmonary resuscitation. Pediatrics 1995; 95: 395–399.

    CAS  PubMed  Google Scholar 

  35. Wyckoff MH, Perlman JM . Use of high-dose epinephrine and sodium bicarbonate during neonatal resuscitation: is there proven benefit? Clin Perinatol 2006; 33: 141–152.

    Article  CAS  Google Scholar 

  36. Wyckoff MH, Wyllie J . Endotracheal delivery of medications during neonatal resuscitation. Clin Perinatol 2006; 33: 153–160.

    Article  Google Scholar 

  37. Guinsburg R, Wyckoff MH . Naloxone during neonatal resuscitation: acknowledging the unknown. Clin Perinatol 2006; 33: 121–132.

    Article  CAS  Google Scholar 

  38. Wyckoff M, Garcia D, Margraf L, Perlman J, Laptook A . Randomized trial of volume infusion during resuscitation of asphyxiated neonatal piglets. Pediatr Res 2007; 61 (4): 415–420.

    Article  CAS  Google Scholar 

  39. Lokesh L, Kumar P, Murki S, Narang A . A randomized controlled trial of sodium bicarbonate in neonatal resuscitation-effect on immediate outcome. Resuscitation 2004; 60: 219–223.

    Article  CAS  Google Scholar 

  40. Speer M, Perlman JM . Modest hypothermia as a neuroprotective strategy in high-risk term infants. Clin Perinatol 2006; 33: 169–182.

    Article  Google Scholar 

  41. McGowen JE, Perlman JM . Glucose management during and after intensive delivery room resuscitation. Clin Perinatol 2006; 33: 183–196.

    Article  Google Scholar 

  42. Byrne S, Goldsmith JP . Non-initiation and discontinuation of resuscitation. Clin Perinatol 2006; 33: 197–218.

    Article  Google Scholar 

  43. Patel H, Beeby PJ . Resuscitation beyond 10 min of term babies born without signs of life. J Pediatr Child Health 2004; 40: 136–138.

    Article  CAS  Google Scholar 

  44. Haddad B, Mercer BM, Livingston JC, Talati A, Sibai BM . Outcome after successful resuscitation of babies born with Apgar scores of 0 at both 1 and 5 min. Am J Obstet Gynecol 2000; 182: 1210–1214.

    Article  CAS  Google Scholar 

  45. Casalaz DM, Marlow N, Speidel BD . Outcome of resuscitation following unexpected apparent stillbirth. Arch Dis Child Fetal Neonatal Ed 1998; 78: F112–F115.

    Article  CAS  Google Scholar 

  46. Jain L, Ferre C, Vidyasagar D, Nath S, Sheftel D . Cardiopulmonary resuscitation of apparently stillborn infants: survival and long-term outcome. J Pediatr 1991; 118: 778.

    Article  CAS  Google Scholar 

  47. International Liaison Committee on Resuscitation 2005 Consensus on Cardiopulmonary resuscitation and emergency cardiovascular care science with treatment recommendations Part 7: Neonatal Resuscitation Resuscitation 2005; 67: 293–303.

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Authors and Affiliations

  1. Division of Neonatal-Perinatal Medicine, Department of Pediatrics, The University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA

    M Escobedo

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  1. M Escobedo
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Correspondence to M Escobedo.

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This paper was supported by a grant from Dey, L.P. Dr. Escobedo has received an unrestricted educational grant from Ross Laboratories.

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Escobedo, M. Moving from experience to evidence: changes in US Neonatal Resuscitation Program based on International Liaison Committee on Resuscitation Review. J Perinatol 28 (Suppl 1), S35–S40 (2008). https://doi.org/10.1038/jp.2008.48

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