Advertisement

Neonatology pp 232-241 | Cite as

Resuscitation of the Newborn

  • Ola D. Saugstad

Abstract

Each year 6–10 million of the approximately 130 million newborn infants born in the world need some kind of resuscitation at birth. In the USA 5–10% of all newborn infants require basic life support in the delivery room, or nursery, constituting at least 200,000 newborn infants in the USA alone. In Western Europe there are similar figures. Approximately 1% of newborns require more extensive resuscitation procedures [1, 2, 3]. Recent estimates indicate that worldwide 814,000 die and an equal number develop sequels after birth asphyxia [4].

Keywords

Continuous Positive Airway Pressure Newborn Infant Spinal Muscular Atrophy Chest Compression Birth Asphyxia 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. 1.
    Perlman JM, Wyllie J, Kattwinkel J et al; Neonatal Resuscitation Chapter Collaborators (2010) Part 11: Neonatal resuscitation: 2010 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations. Circulation 122(16 Suppl 2):S516–S538PubMedCrossRefGoogle Scholar
  2. 2.
    Kattwinkel J, Perlman JM, Aziz K et al (2010) Part 15: Neonatal resuscitation: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation 122(18 Suppl 3):S909–S919PubMedCrossRefGoogle Scholar
  3. 3.
    Richmond S, Wyllie J (2010) European Resuscitation Council Guidelines for Resuscitation 2010 Section 7. Resuscitation of babies at birth. Resuscitation 81:1389–1399PubMedCrossRefGoogle Scholar
  4. 4.
    Black RE, Cousens S, Johnson HL et al; Child Health Epidemiology Reference Group of WHO and UNICEF (2010) Global, regional, and national causes of child mortality in 2008: a systematic analysis. Lancet 375:1969–1987PubMedCrossRefGoogle Scholar
  5. 5.
    Wu YW, Backstrand KH, Zhao S et al (2004) Declining diagnosis of birth asphyxia in California: 1991–2000. Pediatrics 114:1584–1590PubMedCrossRefGoogle Scholar
  6. 6.
    Little M, Järvelin M-R, Neasham DE et al (2007) Factors associated with fall in neonatal intubation rates in the United Kingdom-prospective study. Br J Obst Gynaecol 114:156–164CrossRefGoogle Scholar
  7. 7.
    Wyckoff MH, Perlman JM, Laptook AR (2005) Use of volume expansion during delivery room resuscitation in near-term and term infants. Pediatrics 115:950–955PubMedCrossRefGoogle Scholar
  8. 8.
    Barber CA, Wyckoff MH (2006) Use and efficacy of endotracheal versus intravenous epinephrine during neonatal cardiopulmonary resuscitation in the delivery room. Pediatrics 118:1028–1034PubMedCrossRefGoogle Scholar
  9. 9.
    Kattwinkel J, Niermeyer S, Nadkarni V et al (1999) Resuscitation of the newly born infant: an advisory statement from the Pediatric Working Group of the International Liaison Committee on Resuscitation. Resuscitation 40:71–88PubMedCrossRefGoogle Scholar
  10. 10.
    International Liaison Committee on Resuscitation (2005) 2005 International consensus on cardiopulmonary resuscitation and emergency cardiovascular care science with treatment recommendations. Part 7: Neonatal Resuscitation. Resuscitation 67:293–303CrossRefGoogle Scholar
  11. 11.
    World Health Organization, Department of Reproductive Health and Research (1998) Basic Newborn Resuscitation: a practical guide. WHO, Geneva http://whqlibdoc.who.int/hq/1998/WHO_RHT_MSM_98.1.pdf Google Scholar
  12. 12.
    Emergency Cardiac Care Committee and Subcommittees of the American Heart Association (1992) Guidelines for cardiopulmonary resuscitation and emergency cardiac care, IV: pediatric basic life support. J Am Med Assoc 268:2276–2281CrossRefGoogle Scholar
  13. 13.
    Saugstad OD, Ramji S, Rootwelt T, Vento M (2005) Response to resuscitation of the newborn: early prognostic variables. Acta Paediatr 94:890–895PubMedCrossRefGoogle Scholar
  14. 14.
    O’Donnell CP, Kamlin CO, Davis PG et al (2007) Clinical assessment of infant colour at delivery. Arch Dis Child Fetal Neonatal Ed 92:F465–F467PubMedCrossRefGoogle Scholar
  15. 15.
    Poulton DA, Schmölzer GM, Morley CJ, Davis PG (2011) Assessment of chest rise during mask ventilation of preterm infants in the delivery room. Resuscitation 82:175–179PubMedCrossRefGoogle Scholar
  16. 16.
    Schmölzer GM, Kamlin OC, O’Donnell CP et al (2010) Assessment of tidal volume and gas leak during mask ventilation of preterm infants in the delivery room. Arch Dis Child Fetal Neonatal Ed 95:F393–F397PubMedCrossRefGoogle Scholar
  17. 17.
    Palme-Kilander C, Tunell R, Chiwei Y (1993) Pulmonary gas exchange immediately after birth in spontaneously breathing infants. Arch Dis Child 68:6–10PubMedCrossRefGoogle Scholar
  18. 18.
    Palme-Kilander C, Tunell R (1993) Pulmonary gas exchange during facemask ventilation immediately after birth. Arch Dis Child 68:11–16PubMedCrossRefGoogle Scholar
  19. 19.
    Dawson JA, Kamlin CO, Wong C et al (2010) Changes in heart rate in the first minutes after birth. Arch Dis Child Fetal Neonatal Ed 95:F177–F181PubMedCrossRefGoogle Scholar
  20. 20.
    Kamlin CO, O’Donnell CO, Everest NJ et al (2006) Accuracy of clinical assessment of infant heart rate in the delivery room. Resuscitation 71:319–321PubMedCrossRefGoogle Scholar
  21. 21.
    Saugstad OD, Rootwelt T, Aalen O (1998) Resuscitation of asphyxiated newborn infants with room air or oxygen: an international controlled trial: the Resair 2 study. Pediatrics 102:e1PubMedCrossRefGoogle Scholar
  22. 22.
    Yam CH, Dawson JA, Schmölzer GM et al (2011) Heart rate changes during resuscitation of newly born infants <30 weeks gestation: an observational study. Arch Dis Child Fetal Neonatal Ed 96:F102–F107PubMedCrossRefGoogle Scholar
  23. 23.
    Finer NN, Rich W, Wang C, Leone T (2009) Airway obstruction during mask ventilation of very low birth weight infants during neonatal resuscitation. Pediatrics 123:865–869PubMedCrossRefGoogle Scholar
  24. 24.
    Schmölzer GM, Dawson JA, Kamlin CO et al (2010) Airway obstruction and gas leak during mask ventilation of preterm infants in the delivery room. Arch Dis Child Fetal Neonatal Ed [Epub ahead of print]Google Scholar
  25. 25.
    Milner AD, Vyas H, Hopkin IE (1984) Efficacy of facemask resuscitation at birth. Br Med J (Clin Res Ed) 289:1563–1565CrossRefGoogle Scholar
  26. 26.
    Björklund LJ, Ingimarsson J, Curstedt T et al (1997) Manual ventilation with a few large breaths at birth compromises the therapeutic effect of subsequent surfactant replacement in immature lambs. Pediatr Res 42:348–355PubMedCrossRefGoogle Scholar
  27. 27.
    Jobe AH, Ikegami M (1998) Mechanisms initiating lung injury in the preterm. Early Hum Dev 53:81–94PubMedCrossRefGoogle Scholar
  28. 28.
    Jobe AH, Kramer BW, Moss TJ et al (2002) Decreased indicators of lung injury with continuous positive expiratory pressure in preterm lambs. Pediatr Res 52:387–392PubMedGoogle Scholar
  29. 29.
    Probyn ME, Hooper SB, Dargaville PA et al (2004) Positive end expiratory pressure during resuscitation of premature lambs rapidly improves blood gases without adversely affecting arterial pressure. Pediatr Res 56:198–204PubMedCrossRefGoogle Scholar
  30. 30.
    Polglase GR, Hillman NH, Pillow JJ et al (2008) Positive end-expiratory pressure and tidal volume during initial ventilation of preterm lambs. Pediatr Res 64:517–522PubMedCrossRefGoogle Scholar
  31. 31.
    te Pas AB, Walther FJ (2007) A randomized, controlled trial of delivery-room respiratory management in very preterm infants. Pediatrics 120:322–329CrossRefGoogle Scholar
  32. 32.
    Leone TA, Lange A, Rich W, Finer NN (2006) Disposable colorimetric carbon dioxide detector use as an indicator of a patent airway during noninvasive mask ventilation. Pediatrics 118:e202–e204PubMedCrossRefGoogle Scholar
  33. 33.
    Schmölzer GM, Poulton DA, Dawson JA et al (2011) Assessment of flow waves and colorimetric CO(2) detector for endotracheal tube placement during neonatal resuscitation. Resuscitation 82:307–312PubMedCrossRefGoogle Scholar
  34. 34.
    Garey DM, Ward R, Rich W et al (2008) Tidal volume threshold for colorimetric carbon dioxide detectors available for use in neonates. Pediatrics 121:e1524–e1527PubMedCrossRefGoogle Scholar
  35. 35.
    Wood FE, Morley CJ, Dawson JA, Davis PG (2008) A respiratory function monitor improves mask ventilation. Arc Dis Child Fetal Neonatal Ed 93:F380–F381CrossRefGoogle Scholar
  36. 36.
    Schmörzel GM, Kamlin CO, Dawson JA et al (2010) Respiratory monitoring of neonatal resuscitation. Arch Dis Child Fetal Neonatal Ed 95:F295–F303CrossRefGoogle Scholar
  37. 37.
    Allwood AC, Madar RJ, Baumer JH et al (2003) Changes in resuscitation practice at birth. Arch Dis Child Fetal Neonatal Ed 88:F375–F379PubMedCrossRefGoogle Scholar
  38. 38.
    Rabi Y, Rabi D, Yee W (2007) Room air resuscitation of the depressed newborn: a systematic review and meta-analysis. Resuscitation 72:353–363PubMedCrossRefGoogle Scholar
  39. 39.
    Saugstad OD, Ramji S, Soll RF, Vento M (2008) Resuscitation of newborn infants with 21% or 100% oxygen: an updated systematic review and meta-analysis. Neonatology 94:176–182PubMedCrossRefGoogle Scholar
  40. 40.
    Lakshminrusimha S, Russell JA, Steinhorn RH et al (2007) Pulmonary hemodynamics in neonatal lambs resuscitated with 21%, 50%, and 100% oxygen. Pediatr Res 62:313–318PubMedCrossRefGoogle Scholar
  41. 41.
    Lakshminrusimha S, Russell JA, Steinhorn RH et al (2006) Pulmonary arterial contractility in neonatal lambs increases with 100% oxygen resuscitation. Pediatr Res 59:137–141PubMedCrossRefGoogle Scholar
  42. 42.
    Escrig R, Arruza L, Izquierdo I et al (2008) Achievement of targeted saturation values in extremely low gestational age neonates resuscitated with low or high oxygen concentrations: a prospective, randomized trial. Pediatrics 121:875–881PubMedCrossRefGoogle Scholar
  43. 43.
    Wang CL, Anderson C, Leone TA et al (2008) Resuscitation of preterm neonates by using room air or 100% oxygen. Pediatrics 121:1083–1089PubMedCrossRefGoogle Scholar
  44. 44.
    Vento M, Moro M, Escrig R et al (2009) Preterm resuscitation with low oxygen causes less oxidative stress, inflammation, and chronic lung disease. Pediatrics 124:e439–e449PubMedCrossRefGoogle Scholar
  45. 45.
    Saugstad OD (2006) Oxygen saturations immediately after birth. J Pediatr 148:569–570PubMedCrossRefGoogle Scholar
  46. 46.
    Dawson JA, Kamlin CO, Vento M et al (2010) Defining the reference range for oxygen saturation for infants after birth. Pediatrics 125:e1340–e1347PubMedCrossRefGoogle Scholar
  47. 47.
    Wyckoff MH, Berg RA (2008) Optimizing chest compressions during delivery-room resuscitation. Semin Fetal Neonatal Med 13:410–415PubMedCrossRefGoogle Scholar
  48. 48.
    Christman C, Hemway RJ, Wyckoff MH, Perlman JM (2011) The two-thumb is superior to the two-finger method for administering chest compressions in a manikin model of neonatal resuscitation. Arch Dis Child Fetal Neonatal Ed 96:F99–F101PubMedCrossRefGoogle Scholar
  49. 49.
    Wyckoff MH, Wyllie J (2006) Endotracheal delivery of medications during neonatal resuscitation. Clin Perinatol 33:153–160PubMedCrossRefGoogle Scholar
  50. 50.
    Wyckoff M, Garcia D, Margraf L et al (2007) Randomized trial of volume infusion during resuscitation of asphyxiated neonatal piglets. Pediatr Res 61:415–420PubMedCrossRefGoogle Scholar
  51. 51.
    Wyckoff MH, Perlman JM (2006) Use of high-dose epinephrine and sodium bicarbonate during neonatal resuscitation: is there proven benefit? Clin Perinatol 33:141–151PubMedCrossRefGoogle Scholar
  52. 52.
    Gupta V, Bhatia BD, Mishra OP (1996) Meconium stained amniotic fluid: antenatal, intrapartum and neonatal attributes. Indian Pediatr 33:293–297PubMedGoogle Scholar
  53. 53.
    Finer NN, Horbar DH, Carpenter JH; the Vermont Oxford Network (1999) Cardiopulmonary resuscitation in the very low birth weight infant: the Vermont Oxford Experience. Pediatrics 104:428–434PubMedCrossRefGoogle Scholar
  54. 54.
    Leone TA, Rich W, Finer NN (2006) A survey of delivery room resuscitation practices in the United States. Pediatrics 117:e164–e175PubMedCrossRefGoogle Scholar
  55. 55.
    Leone TA, Rich W, Finer NN (2005) Neonatal intubation: success of pediatric trainees. J Pediatr 146:638–641PubMedCrossRefGoogle Scholar
  56. 56.
    Finer N, Leone T (2009) Oxygen saturation monitoring for the preterm infant: the evidence basis for current practice. Pediatr Res 65:375–380PubMedCrossRefGoogle Scholar
  57. 57.
    Brugada M (2008) Using intensive care technology in the delivery room: a new concept for the resuscitation of extremely preterm neonates. Pediatrics 122:1113–1116PubMedCrossRefGoogle Scholar
  58. 58.
    Vento M, Cheung PY, Aguar M (2009) The first golden minutes of the extremely-low-gestational-age neonate: a gentle approach. Neonatology 95:286–298PubMedCrossRefGoogle Scholar
  59. 59.
    Victorin LH, Deverajan LV, Curstedt T, Robertson B (1990) Surfactant replacement in spontaneously breathing babies with hyaline membrane disease—a pilot study. Biol Neonate 58:121–126PubMedCrossRefGoogle Scholar
  60. 60.
    Morley CJ, Davis PG (2008) Advances in neonatal resuscitation: supporting transition Arch Dis Child Fetal Neonatal Ed 93:F334–F336PubMedCrossRefGoogle Scholar
  61. 61.
    Skupski DW, Chervenak FA, McCullough LB et al (2010) Ethical dimensions of periviability. J Perinat Med 38:579–583PubMedCrossRefGoogle Scholar
  62. 62.
    McGowan JE, Perlman JM (2006) Glucose management during and after intensive delivery room resuscitation. Clin Perinatol 33:183–196PubMedCrossRefGoogle Scholar
  63. 63.
    Azzopardi DV, Strohm B, Edwards AD et al; TOBY Study Group (2009) Moderate hypothermia to treat perinatal asphyxial encephalopathy. N Engl J Med 361:1349–1358 [Erratum in: N Engl J Med 2010;362:1056]PubMedCrossRefGoogle Scholar
  64. 64.
    Perlman JM (2006) Hyperthermia in the delivery: potential impact on neonatal mortality and morbidity. Clin Perinatol 33:55–63PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Italia 2012

Authors and Affiliations

  • Ola D. Saugstad
    • 1
  1. 1.Department of Pediatric Research, RikshospitaletOslo University Hospital, University of OsloOsloNorway

Personalised recommendations