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Chapter 36 - Resuscitation of the Newborn

from Section 7 - Neonatal Emergencies and the Management of Immediate Neonatal Problems

Published online by Cambridge University Press:  06 May 2021

Edwin Chandraharan
St George's University of London
Sir Sabaratnam Arulkumaran
St George's University of London
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The primary reason for resuscitation in the newborn infant differs from that in adults. While most adults requiring resuscitation will have a cardiac event, the newborn infant’s heart is healthy and it will usually be a respiratory (hypoxic) event that will have compromised the newborn. Particular attention to management of the Airway and Breathing is therefore imperative.

The fetal lung is filled with fluid (approximately 30 mL/kg, which equates to about 100 mL in an average term baby). This is absorbed rapidly soon after birth due to various adaptive processes, the lung becomes aerated and a functional residual capacity (FRC) established. In compromised hypoxic infants this may not occur and the onset of breathing may be delayed. These babies need intervention.

Obstetric and Intrapartum Emergencies
A Practical Guide to Management
, pp. 261 - 272
Publisher: Cambridge University Press
Print publication year: 2021

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Wyllie, J, Ainsworth, S, Tinnion, R; Resuscitation Council (UK). Guidelines: Resuscitation and support of transition of babies at birth. 2015. Scholar
Oei, JL, Vento, M, Rabi, Y, et al. Higher or lower oxygen for delivery room resuscitation of preterm infants below 28 completed weeks gestation: a meta-analysis. Arch Dis Child Fetal Neonatal Ed. 2017;102:F24.CrossRefGoogle ScholarPubMed
Meyer, A, Nadkarni, V, Pollock, A, et al. Evaluation of the Neonatal Resuscitation Program’s recommended chest compression depth using computerized tomography imaging. Resuscitation. 2010;81(5):544–8.CrossRefGoogle ScholarPubMed
Wu, W, Shi, Y, Li, F, Wen, Z, Liu, H. Surfactant administration via a thin endotracheal catheter during spontaneous breathing in preterm infants. Pediatr Pulmonol. 2017;52:844–54.CrossRefGoogle Scholar
Aldana-Aguirre, JC, Pinto, M, Featherstone, RM, et al. Less invasive surfactant administration versus intubation for surfactant delivery in preterm infants with respiratory distress syndrome: a systematic review and meta-analysis. Arch Dis Child Fetal Neonatal Ed. 2017;102:F17F23.CrossRefGoogle ScholarPubMed
Weisz, DE, Shivananda, S, Asztalos, E. et al. Intrapartum magnesium sulphate and need for delivery room resuscitation. Arch Dis Child Fetal Neonatal Ed. 2015;100(1):F5965.CrossRefGoogle ScholarPubMed
Jacquemyn, Y, Zecic AJacquemyn, Y, Zecic, A, et al. The use of magnesium in non pre-eclamptic pregnant women: fetal/neonatal neuroprotection. Arch Gynecol Obstet. 2015;291(5):969–75.CrossRefGoogle Scholar
Oddie, S, Tuffnell, DJ, McGuire, W. Antenatal magnesium sulphate: neuroprotection for preterm infants. Arch Dis Child Fetal Neonatal Ed. 2015;100(6):F553–7.Google Scholar
Marlow, N, Wolke, D, Bracewell, MA, Samara, M; EPICure Study Group. Neurologic and developmental disability at six years of age after extremely preterm birth. N Engl J Med. 2005;352(1):919.CrossRefGoogle ScholarPubMed

Further Reading

Biban, P, Filipovic-Grcic, B, Biarent, D, Manzoni, P; International Liaison Committee on Resuscitation (ILCOR); European Resuscitation Council (ERC); American Heart Association (AHA); American Academy of Pediatrics (AAP). New cardiopulmonary resuscitation guidelines 2010: managing the newly born in delivery room. Early Hum Dev. 2011;87(Suppl 1):S911.CrossRefGoogle ScholarPubMed
British Association of Perinatal Medicine. The management of babies born extremely preterm at less than 26 weeks of gestation: a framework for clinical practice at the time of birth. Arch Dis Child. 2009;94(1):F2–5.Google Scholar
Dawson, JA, Kamlin, OF, Vento, M, et al. Defining the reference range for oxygen saturation for infants after birth. Paediatrics. 2010;125:e1340e1347.CrossRefGoogle ScholarPubMed
Kasdorf, E, Laptook, A, Azzopardi, D, et al. Improving infant outcome with a 10 min Apgar of 0. Arch Dis Child Fetal Neonatal Ed. 2015;100:F102.CrossRefGoogle ScholarPubMed
Kattwinkel, J, Perlman, JM, Aziz, K, et al. Part 15: Neonatal resuscitation: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 2010;122(18 Suppl 3):S909–19.CrossRefGoogle ScholarPubMed
Laptook, AR, Watkinson, M. Temperature management in the delivery room. Semin Fetal Neonat Med. 2008;13:383391.CrossRefGoogle ScholarPubMed
Mcdonald, SJ, Middledon, P. Effect of timing of umbilical cord clamping of term infants on maternal and neonatal outcomes. Cochrane Pregnancy and Childbirth Group. July 2013.CrossRefGoogle Scholar
Morley, CJ, Davis, PG. Advances in neonatal resuscitation: supporting transition. Arch Dis Child. 2008;93:F334F336.CrossRefGoogle ScholarPubMed
Nolan, JP, Soar, J, Zideman, DA, et al. European Resuscitation Council Guidelines for Resuscitation. Resuscitation. 2010;81:1219–76.Google ScholarPubMed
Oei, JL, Saugstad, OD, Lui, K, et al. Targeted oxygen in the resuscitation of preterm infants, a randomized clinical trial. Pediatrics. 2017;139(1):e20161452.CrossRefGoogle ScholarPubMed
Rabe, H, Diaz-Rossello, JL, Duley, L, Dowswell, T. 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. 2012;(8). Article No. CD003248. DOI: 10.1002/14651858.CD003248.pub3.CrossRefGoogle Scholar
Resuscitation Council (UK). Newborn Life Support. Resuscitation Guidelines. 2010;118–27.Google Scholar
Resuscitation Council (UK). Newborn Life Support, 4th ed. Resuscitation Guidelines. 2016.Google Scholar
Saugstad, OD. New guidelines for newborn resuscitation–a critical evaluation. Acta Paediatr. 2011;100(8):1058–62.Google ScholarPubMed
Saugstad, OD, Ramji, S, Soll, RF, Vento, M. Resuscitation of newborn infants with 21% or 100% oxygen: an updated systematic review and meta-analysis. Neonatology. 2008;94(3):176–82.CrossRefGoogle ScholarPubMed
Vento, M, Saugstad, OD. Resuscitation of the term and preterm infant. Semin Fetal Neonatal Med. 2010 Aug;15(4):216222.CrossRefGoogle ScholarPubMed
WHO. Guidelines on Basic Newborn Resuscitation. 2012. Wyckoff, MH, Aziz, K, Escobedo, MB, et al. Part 13: Neonatal Resuscitation: 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 2015; 132:S543.;jsessionid=03BADAAA38FDDB2CF0F87A9DF4975D06?sequence=1CrossRefGoogle Scholar

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