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Early initiation of basic resuscitation interventions including face mask ventilation may reduce birth asphyxia related mortality in low-income countries.
MedLine Citation:
PMID:  22198423     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
AIM OF THE STUDY: Early initiation of basic resuscitation interventions within 60seconds in apneic newborn infants is thought to be essential in preventing progression to circulatory collapse based on experimental cardio- respiratory responses to asphyxia. The objectives were to describe normal transitional respiratory adaption at birth and to assess the importance of initiating basic resuscitation within the first minutes after birth as it relates to neonatal outcome. METHODS: This is an observational study of neonatal respiratory adaptation at birth in a rural hospital in Tanzania. Research assistants (n=14) monitored every newborn infant delivery and the response of birth attendants to a depressed baby. Time to initiation of spontaneous respirations or time to onset of breathing following stimulation/suctioning, or face mask ventilation (FMV) in apneic infants, and duration of FMV were recorded. RESULTS: 5845 infants were born; 5689 were liveborn, among these 4769(84%) initiated spontaneous respirations; 93% in ≤30seconds and 99% in ≤60seconds. Basic resuscitation (stimulation, suction, and/or FMV) was attempted in 920/5689(16.0%); of these 459(49.9%) received FMV. Outcomes included normal n=5613(96.0%), neonatal deaths n=56(1.0%), admitted neonatal area n=20(0.3%), and stillbirths n=156(2.7%). The risk for death or prolonged admission increases 16% for every 30seconds delay in initiating FMV up to six minutes (p=0.045) and 6% for every minute of applied FMV (p=0.001). CONCLUSIONS: : The majority of lifeless babies were in primary apnea and responded to stimulation/suctioning and/or FMV. Infants who required FMV were more likely to die particularly when ventilation was delayed or prolonged.
Authors:
Hege Langli Ersdal; Estomih Mduma; Erling Svensen; Jeffrey Perlman
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-12-22
Journal Detail:
Title:  Resuscitation     Volume:  -     ISSN:  1873-1570     ISO Abbreviation:  -     Publication Date:  2011 Dec 
Date Detail:
Created Date:  2011-12-26     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0332173     Medline TA:  Resuscitation     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2011. Published by Elsevier Ireland Ltd.
Affiliation:
Department of Anaesthesiology and Intensive Care, Stavanger University Hospital, Norway; Department of International Health, University of Oslo, Norway.
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