👉Heart Rate Determination in Newborns at Risk for Resuscitation in a Low-Resource Setting: A Randomized Controlled Trial

📌HR assessment by auscultation was more accurate compared with cord palpation, but both may provide adequate clinical information to healthcare providers in terms of HR ranges. The clinical advantage of providing a stethoscope in low-resource settings remains to be established.

🔗https://www.jpeds.com/article/S0022-3476(20)30183-9/fulltext

#resuscitation #neonatology #heartrate #auscultation

👉ELBW infants receive inadvertent sodium load above the recommended intake

📌Sodium load during the first 2 postnatal weeks of ELBW infants was significantly higher than recommended owing to inadvertent sodium intake and was associated with a higher risk of subsequent morbidity and mortality, although the study design does not allow conclusions on causality. Replacement of 0.9% saline with alternative carrier solutions might reduce sodium intake.

🔗https://www.nature.com/articles/s41390-020-0867-9?platform=hootsuite

#na #neonatology #resuscitation #infusion #nature

👉Not Crying After Birth as a Predictor of Not Breathing

📌All nonbreathing infants after birth do not cry at birth. A proportion of noncrying but breathing infants at birth are not breathing by 1 and 5 minutes and have a risk for predischarge mortality. With this study, we provide evidence of an association between noncrying and nonbreathing. This study revealed that noncrying but breathing infants require additional care. We suggest noncrying as a clinical sign for initiating resuscitation and a possible denominator for measuring coverage of resuscitation.

🔗https://pediatrics.aappublications.org/content/145/6/e20192719

#breathing #resuscitation #aap #pediatrics #crying

👉Consensus on Science with Treatment Recommendations

📌ILCOR:
- Tracheal suctioning of meconium at birth for non-vigorous infants: a systematic review and meta-analysis (NLS #865): Systematic Review

- Initial Oxygen Concentration for Preterm Neonatal Resuscitation: (NLS 864) Systematic Review

- Removal of foreign body airway obstruction (BLS): Systematic Review

- Advanced Airway Interventions in Pediatric Cardiac Arrest (PLS): Systematic Review

🔗https://costr.ilcor.org/

🔗https://costr.ilcor.org/document/?q=&category=neonatal-life-support&domain=&date_from=&date_to=&order=

#resuscitation #ilcor

🅰️

👉Outcomes of endotracheal suctioning in non-vigorous neonates born through meconium-stained amniotic fluid: a systematic review and meta-analysis

📌Outcomes of non-endotracheal suctioning (non-ETS) versus ETS in non-vigorous meconium-stained neonates = no difference

🔗https://fn.bmj.com/content/early/2020/06/18/archdischild-2020-318941

#resuscitation #meconium #suctioning

👉Nasal insertion depths for neonatal intubation

📌New reference charts/ formulas for optimising nasal intubation depths.
Spoiler alert: It is NOT (weight)+7cms or (weight x 1.5) +6cms!

🔗http://dx.doi.org/10.1136/archdischild-2020-319140

#intubation #resuscitation

👉Randomised controlled trial: Shoulder–umbilicus length versus body weight measurement for optimal endotracheal tube depth estimation in ventilated infants

📌In the experimental group, fewer infants showed a need for tube adjustment than in the control group. While a larger study may be necessary to show statistical significance, the difference shown in this study may be large enough to be of clinical significance.

🔗https://onlinelibrary.wiley.com/doi/10.1111/jpc.14705

#intubation #ett #resuscitation

👉Delivery of Positive End-Expiratory Pressure Using Self-Inflating Bags during Newborn #Resuscitation Is Possible Despite #Mask Leak

📌Mask leak up to 80% did not impair the provision of recommended PEEP or tidal volumes during BMV with a self-inflating bag. High or low ventilation rates did not significantly affect PIP or PEEP. Expired volumes were reduced at ventilation rates >60/min.

🔗https://doi.org/10.1159/000507829

#karger

👉Duration of #Resuscitation at Birth, Mortality, and Neurodevelopment: A Systematic Review

📌Infants with ongoing #CPR at 10 minutes after birth are at high risk for mortality and neurodisability, but survival without moderate or severe NDI is possible. One specified duration of CPR is unlikely to uniformly predict survival or survival without neuroimpairment.

🔗https://doi.org/10.1542/peds.2020-1449

🅰️

👉Positive End-Expiratory Pressure in Newborn Resuscitation Around Term: A Randomized Controlled Trial

📌We found no evidence for improved heart rate response during bag-mask #ventilation with PEEP compared with no PEEP. The #PEEP valve delivered a median PEEP within the intended range. The findings do not support routine use of PEEP during #resuscitation of newborns around term.

🔗https://doi.org/10.1542/peds.2020-0494

🅰️

👉#Resuscitation of non-vigorous neonates born through #meconium-stained amniotic fluid: post policy change impact analysis

📌The policy change towards not routinely suctioning non-vigorous neonates born through MSAF at birth was not associated with an increase in the local incidence of #MAS and was associated with fewer #NICU admissions.

🔗https://doi.org/10.1136/archdischild-2020-319771
https://pediatrics.aappublications.org/content/142/6/e20181485/tab-figures-data

📌Documentation during neonatal #resuscitation: a systematic review

👉There is little literature regarding accuracy of #documentation during neonatal resuscitation, but current quality of documentation seems to be unsatisfactory. There is a need for consensus guidelines and innovative solutions in newborn resuscitation documentation.

🔗http://dx.doi.org/10.1136/archdischild-2020-319948

The European #Resuscitation Council has produced the newborn life support guidelines, which are based on the International Liaison Committee on Resuscitation (ILCOR) 2020 Consensus on Science and Treatment Recommendations (CoSTR) for Neonatal Life Support.

New guidelines: cprguidelines.eu/
ILCOR 2020: doi.org/10.1542/peds.2020-038505E
CoSTR 2020: doi/epub/10.1161/CIR.0000000000000895

Proximal humeral head and distal femoral end beside the recommended proximal tibia might be alternative IO areas which may lead to further IO puncture sites in neonates.

#resuscitation
https://doi.org/10.1016/j.resuscitation.2021.04.004
*The full text is in the comments

For newly born infants between 29 and 31 weeks of GA, an initial FiO2 of 0.3 hit the target defined by the International Liaison Committee on Resuscitation (#ILCOR) best. Newborn infants with GA <29 weeks in need of PPV and supplementary #oxygen starting with FiO2 0.3 and adjusting the FiO2 to reach SpO2 of 80% within 5 min of life for best outcomes.

#resuscitation
doi.org/10.1159/000516261
*The full text is in the comments

The quality of pediatric #resuscitation significantly improved when using real-time feedback. However, attention shifted from the manikin and other equipment to the feedback device and subjective workload increased, respectively.

https://rdcu.be/cpPUH

The use of ECG in the DR during preterm resuscitation did not reduce time to
stabilization.

#resuscitation
https://doi.org/10.1038/s41390-021-01731-z

Stimulation of non-­crying neonates with intact cord was associated with more spontaneous breathing than among infants who were stimulated with cord clamped. Intact cord stimulation may help establish spontaneous breathing in apnoeic neonates, but residual confounding variables may be contributing to the findings.

#resuscitation
doi:10.1136/bmjpo-2021-001207

Many gaps in knowledge including the optimal dosing, best route and timing of epinephrine administration warrant further studies.

#resuscitation
doi:10.3390/children6040051

ILCOR summary statement

#resuscitation
DOI: 10.1161/CIR.0000000000001017