Skip to main content

Advertisement

SpringerLink
Log in

Recent Update on Neonatal Resuscitation

  • Review Article
  • Published:
Indian Journal of Pediatrics Aims and scope Submit manuscript

Abstract

Every 5 y, the International Liaison Committee on Resuscitation publishes consensus on cardiopulmonary resuscitation, and emergency cardiovascular science and treatment recommendations. The latest update on neonatal resuscitation guidelines was published in 2020. Here, the authors review the important changes in the recent recommendations, including initial steps of resuscitation, umbilical cord management, management of nonvigorous infants born through meconium-stained amniotic fluid, sustained inflation in preterm infants, epinephrine, vascular access, timing of discontinuation of resuscitative effort, and team briefing and debriefing.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Ersdal HL, Mduma E, Svensen E, Perlman JM. Early initiation of basic resuscitation interventions including face mask ventilation may reduce birth asphyxia related mortality in low-income countries: a prospective descriptive observational study. Resuscitation. 2012;83:869–73.

    Article  Google Scholar 

  2. Niles DE, Cines C, Insley E, et al. Incidence and characteristics of positive pressure ventilation delivered to newborns in a US tertiary academic hospital. Resuscitation. 2017;115:102–9.

    Article  Google Scholar 

  3. Kattwinkel J, Perlman JM, Aziz K, et al. Neonatal resuscitation: 2010 american heart association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation. 2010;122:S909–19.

    Article  Google Scholar 

  4. Perlman JM, Risser R. Cardiopulmonary resuscitation in the delivery room: associated clinical events. Arch Pediatr Adolesc Med. 1995;149:20–5.

    Article  CAS  Google Scholar 

  5. Barber CA, Wyckoff MH. Use and efficacy of endotracheal versus intravenous epinephrine during neonatal cardiopulmonary resuscitation in the delivery room. Pediatrics. 2006;118:1028–34.

    Article  Google Scholar 

  6. Soraisham AS, Lodha AK, Singhal N, et al. Neonatal outcomes following extensive cardiopulmonary resuscitation in the delivery room for infants born at less than 33 weeks gestational age. Resuscitation. 2014;85:238–43.

    Article  Google Scholar 

  7. Wyckoff MH, Salhab WA, Heyne RJ, Kendrick DE, Stoll BJ, Laptook AR. National institute of child health and human development neonatal research network. outcome of extremely low birth weight infants who received delivery room cardiopulmonary resuscitation. J Pediatr. 2012;160:239–44.

  8. Finer NN, Horbar JD, Carpenter JH. Cardiopulmonary resuscitation in the very low birth weight infant: the Vermont Oxford network experience. Pediatrics. 1999;104:428–34.

    Article  CAS  Google Scholar 

  9. Bloom R, Cropley C. Textbook of neonatal resuscitation/Ronald S, Vol 1. Elk Grove Village (IL): American Academy of Pediatrics; 1987.

  10. Niermeyer S, Kattwinkel J, Van Reempts P, et al. An excerpt from the guidelines 2000 for cardiopulmonary resuscitation and emergency cardiovascular care: International consensus on science. contributors and reviewers for the neonatal resuscitation guidelines. Pediatrics. 2000;106:E29.

    Article  CAS  Google Scholar 

  11. International liaison committee on resuscitation. International consensus on cardiopulmonary resuscitation and emergency cardiovascular care science with treatment recommendations. Part 7: neonatal resuscitation. Circulation. 2005;67:293–303.

    Google Scholar 

  12. Perlman JM, Wyllie J, Kattwinkel J, et al. Part 11: neonatal resuscitation: 2010 international consensus on cardiopulmonary resuscitation and emergency cardiovascular care science with treatment recommendations. Circulation. 2010;122(16 Suppl 2):S516–38.

    PubMed  Google Scholar 

  13. Perlman JM, Wyllie J, Kattwinkel J, et al. Part 7: neonatal resuscitation: 2015 international consensus on cardiopulmonary resuscitation and emergency cardiovascular care science with treatment recommendations. Circulation. 2015;132(16 Suppl 1):S204–41.

    PubMed  Google Scholar 

  14. Wyckoff MH, Wyllie J, Aziz K, et al. Neonatal life support: 2020 international consensus on cardiopulmonary resuscitation and emergency cardiovascular care science with treatment recommendations. Circulation. 2020;142(Suppl 1):S185–221.

  15. Aziz K, Lee HC, Escobedo MB, et al. Part 5: Neonatal resuscitation: 2020 American heart association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation. 2020;142(16 Suppl 2):S524–50.

  16. Fogarty M, Osborn DA, Askie L, et al. Delayed vs early umbilical cord clamping for preterm infants: a systematic review and meta-analysis. Am J Obstet Gynecol. 2018;218:1–18.

  17. Seidler AL, Gyte GML, Rabe H, et al. Umbilical cord management for newborns <34 weeks' gestation: a meta-analysis. Pediatrics. 2021;147:e20200576.

  18. Rabe H, Gyte GM, Díaz-Rossello JL, Duley L. Effect of timing of umbilical cord clamping and other strategies to influence placental transfusion at preterm birth on maternal and infant outcomes. Cochrane Database Syst Rev. 2019;9:CD003248.

  19. Committee on Obstetric Practice. Committee opinion no. 684: delayed umbilical cord clamping after birth. Obstet Gynecol. 2017;129:e5–e10.

    Article  Google Scholar 

  20. Katheria A, Reister F, Essers J, et al. Association of umbilical cord milking vs delayed umbilical cord clamping with death or severe intraventricular hemorrhage among preterm infants. JAMA. 2019;322:1877–86.

    Article  Google Scholar 

  21. Balasubramanian H, Ananthan A, Jain V, Rao SC, Kabra N. Umbilical cord milking in preterm infants: a systematic review and meta-analysis. Arch Dis Child Fetal Neonatal Ed. 2020;105:572–80.

    Article  Google Scholar 

  22. Trevisanuto D, Strand ML, Kawakami MD, et al. International liaison committee on resuscitation neonatal life support task force tracheal suctioning of meconium at birth for non-vigorous infants: a systematic review and meta-analysis. Resuscitation. 2020;149:117–26.

    Article  Google Scholar 

  23. Kamlin CO, O’Donnell CP, Everest NJ, Davis PG, Morley CJ. Accuracy of clinical assessment of infant heart rate in the delivery room. Resuscitation. 2006;71:319–21.

    Article  Google Scholar 

  24. Owen CJ, Wyllie JP. Determination of heart rate in the baby at birth. Resuscitation. 2004;60:213–7.

    Article  Google Scholar 

  25. Voogdt KG, Morrison AC, Wood FE, van Elburg RM, Wyllie JP. A randomised, simulated study assessing auscultation of heart rate at birth. Resuscitation. 2010;81:1000–3.

    Article  Google Scholar 

  26. Chitkara R, Rajani AK, Oehlert JW, Lee HC, Epi MS, Halamek LP. The accuracy of human senses in the detection of neonatal heart rate during standardized simulated resuscitation: implications for delivery of care, training and technology design. Resuscitation. 2013;84:369–72.

    Article  Google Scholar 

  27. Mizumoto H, Tomotaki S, Shibata H, et al. Electrocardiogram shows reliable heart rates much earlier than pulse oximetry during neonatal resuscitation. Pediatr Int. 2012;54:205–7.

    Article  Google Scholar 

  28. Katheria A, Rich W, Finer N. Electrocardiogram provides a continuous heart rate faster than oximetry during neonatal resuscitation. Pediatrics. 2012;130:e1177–81.

    Article  Google Scholar 

  29. van Vonderen JJ, Hooper SB, Kroese JK, et al. Pulse oximetry measures a lower heart rate at birth compared with electrocardiography. J Pediatr. 2015;166:49–53.

    Article  Google Scholar 

  30. Hodgson KA, Kamlin COF, Rogerson S, Thio M. ECG monitoring in the delivery room is not reliable for all patients. Arch Dis Child Fetal Neonatal. 2018;103:F88.

  31. Patel S, Cheung PY, Solevåg AL, et al. Pulseless electrical activity: a misdiagnosed entity during asphyxia in newborn infants? Arch Dis Child Fetal Neonatal. 2019;104:F215–F17.

    Article  Google Scholar 

  32. Luong DH, Cheung P-Y, Lee T-F, Schmölzer GM. Electrocardiography vs auscultation to assess heart rate during cardiac arrest with pulseless electrical activity in newborn infants. Front Pediatr. 2018;6:S204.

    Article  Google Scholar 

  33. Sillers L, Handley SC, James JR. Pulseless electrical activity complicating neonatal resuscitation. Neonatology. 2018;115:95–8.

    Article  Google Scholar 

  34. Luong D, Cheung PY, Barrington KJ, et al. Cardiac arrest with pulseless electrical activity rhythm in newborn infants: a case series. Arch Dis Child Fetal Neonatal Ed. 2019;104:F572–4.

    Article  Google Scholar 

  35. Klingenberg C, Sobotka KS, Ong T, et al. Effect of sustained inflation duration; resuscitation of near-term asphyxiated lambs. Arch Dis Child Fetal Neonatal Ed. 2013;98:F222–F7.

    Article  Google Scholar 

  36. te Pas AB, Siew M, Wallace MJ, et al. Effect of sustained inflation length on establishing functional residual capacity at birth in ventilated premature rabbits. Pediatr Res. 2009;66:295–300.

    Article  Google Scholar 

  37. Kapadia VS, Urlesberger B, Soraisham A, et al. International liaison committee on resuscitation neonatal life support task force. sustained lung inflations during neonatal resuscitation at birth: a meta-analysis. Pediatrics. 2021;147:e2020021204.

  38. Guinsburg R, de Almeida MFB, de Castro JS, et al. T-piece versus self-inflating bag ventilation in preterm neonates at birth. Arch Dis Child Fetal Neonatal Ed. 2018;103:F49–55.

    Article  Google Scholar 

  39. Thakur A, Saluja S, Modi M, et al. T-piece or self-inflating bag for positive pressure ventilation during delivery room resuscitation: an RCT. Resuscitation. 2015;90:21–4.

    Article  Google Scholar 

  40. Escobedo MB, Aziz K, Kapadia VS, et al. American heart association focused update on neonatal resuscitation: an update to the american heart association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation. 2019;140:e922–e30.

  41. Sankaran D, Chandrasekharan PK, Gugino SF, et al. Randomised trial of epinephrine dose and flush volume in term newborn lambs. Arch Dis Child Fetal Neonatal Ed. 2021;0:F1–F6.

  42. Bang A, Patel A, Bellad R, et al. Helping babies breathe (HBB) training: what happens to knowledge and skills over time? BMC Pregnancy Childbirth. 2016;16:364.

    Article  Google Scholar 

  43. Arlington L, Kairuki AK, Isangula KG, et al. Implementation of “helping babies breathe”: a 3-year experience in Tanzania. Pediatrics. 2017;139:e20162132.

    Article  Google Scholar 

  44. Mduma E, Ersdal H, Svensen E, Kidanto H, Auestad B, Perlman J. Frequent brief on-site simulation training and reduction in 24-h neonatal mortality–an educational intervention study. Resuscitation. 2015;93:1–7.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Section of Neonatology, Department of Pediatrics, Alberta Children’s Hospital Research Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada

    Amuchou S. Soraisham

  2. NICU Foothills Medical Centre, University of Calgary, Calgary, Alberta, T2N 2T9, Canada

    Amuchou S. Soraisham

  3. Section of Neonatology, Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada

    Ankur Srivastava

Authors
  1. Amuchou S. Soraisham
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ankur Srivastava
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

Both authors (ASS and AS) contributed in writing the article. ASS is the guarantor for this paper.

Corresponding author

Correspondence to Amuchou S. Soraisham.

Ethics declarations

Conflict of Interest

None.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Soraisham, A.S., Srivastava, A. Recent Update on Neonatal Resuscitation. Indian J Pediatr 89, 279–287 (2022). https://doi.org/10.1007/s12098-021-03796-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12098-021-03796-4

Keywords

Search

Navigation