The use of cardiopulmonary resuscitation in the delivery room (CPR) has been associated with very poor outcomes in the very low birth weight infant, especially < 750 grams. However, all of the literature to date involves very small numbers of infants with the largest reviewing 156 infants from a single institution (Davis, D Pediatr 1993;92:447) We reviewed the Vermont Oxford Network database to determine the utilization of delivery room CPR(cardiac compressions, epinephrine or both) and the neonatal outcomes of inborn infants of 501 to 1500 grams at birth without congenital malformations. The data were collected from 196 inborn neonatal units participating in the Network in 1994 - 1996. Information was available for 27,196 infants, 23,889 of whom survived (87.8%). Overall, 989 of 1591 infants with CPR survived(62.1%) compared with 89.4% of the 25,580 infants without CPR, p<0.001. Survival was greater in all weight groups for infants without CPR, and for all infants without CPR controlling for BW, p<0.001. Overall Grade 3 or 4 IVH(SIVH) occurred in 15.3% in infants with CPR compared with 4.9% in No CPR infants and was significantly more common in survivors of CPR, p<0.001. For infants of less than 750 gms, there was no significant difference in the occurrence of SIVH for infants who did or did not receive CPR possibly reflecting decisions regarding resuscitation. These results require further evaluation regarding the appropriateness of delivery room CPR, and the neurodevelopmental outcomes of the surviving infants. Nevertheless, these data demonstrate that survival without SIVH occurred in 52.7% of infants between 501 and 1500 gm who received such CPR. The number and% of infants who received CPR, and the proportion of infants receiving CPR who survived and survived without SIVH are shown in the Table.

Table 1 No caption available.
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