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Resuscitation practices for infants in the NICU, PICU and CICU: results of a national survey

Journal of Perinatology volume 37, pages 172–176 (2017)Cite this article

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Abstract

Objective:

Infants requiring resuscitation at birth are resuscitated using neonatal resuscitation guidelines. Sometime after birth, resuscitation practice must transition to pediatric guidelines. There is no evidence on when this transition should occur. The objective of this study was to describe infant resuscitation practices in Neonatal Intensive Care Units (NICUs), Pediatric Intensive Care Units (PICUs) and Cardiac Intensive Care Units (CICUs).

Study Design:

An electronic survey was sent to medical directors of NICUs, PICUs and CICUs in the U.S. The survey examined resuscitation practices, and preference for use of neonatal or pediatric guidelines, for different postnatal ages, clinical scenarios and etiologies of arrest.

Results:

A total of 152 responses were received, including 118 NICUs, 19 PICUs and 15 CICUs. The majority of NICU responders used greater than 28 days as the time to change from neonatal to pediatric guidelines. The majority of PICU and CICU transitioned to pediatric guidelines immediately after birth. Pediatric guidelines were preferred in the PICU and CICU regardless of the arrest etiology. NICU responders favored pediatric guidelines only if the arrest was cardiac.

Conclusions:

Our results suggest that infants are resuscitated using neonatal guidelines in the NICU and pediatric guidelines in the PICU and CICU, even if they are the same age and have the same etiology of arrest. There is no agreement on the time to change from neonatal to pediatric guidelines. Further research comparing the outcomes of infants resuscitated in these different units could inform future guideline refinement.

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Acknowledgements

The authors would like to acknowledge Dr Clyde Wright for his assistance in the editing of this manuscript.

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Authors and Affiliations

  1. Division of Neonatology, University of Colorado School of Medicine and Children’s Hospital Colorado, Aurora, CO, USA

    N Ali, J Barry & T Grover

  2. Division of Neonatology, University of Washington School of Medicine, WA, USA

    T Sawyer

  3. Division of Neonatology, Children’s Hospital of Philadelphia, Philadelphia, PA, USA

    A Ades

Authors
  1. N Ali
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  2. T Sawyer
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  3. J Barry
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  4. T Grover
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Corresponding author

Correspondence to N Ali.

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The authors declare no conflict of interest.

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Supplementary Information accompanies the paper on the Journal of Perinatology website

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Ali, N., Sawyer, T., Barry, J. et al. Resuscitation practices for infants in the NICU, PICU and CICU: results of a national survey. J Perinatol 37, 172–176 (2017). https://doi.org/10.1038/jp.2016.193

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  • DOI: https://doi.org/10.1038/jp.2016.193

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