Document Detail

Neonatal resuscitation: foetal physiology and pathophysiological aspects.
MedLine Citation:
PMID:  22717724     Owner:  NLM     Status:  MEDLINE    
Although approximately 10% of all newborn infants receive some form of assistance after birth, only 1% of neonates require more advanced measures of life support. Because such situations cannot always be anticipated, paediatricians and neonatologists are frequently unavailable and resuscitation is delegated to the anaesthesiologist. The International Liaison Committee on Resuscitation, the European Resuscitation Council and the American Heart Association have recently updated the guidelines on neonatal resuscitation. The revised guidelines propose a simplified resuscitation algorithm that highlights the central role of respiratory support and promotes an increasing heart rate as the best indicator for effective ventilation. The most striking change in the new guidelines is the recommendation to start resuscitation in term infants with room air rather than 100% oxygen. Continuous pulse oximetry is recommended to monitor both heart rate and an appropriate increase in preductal oxygen saturation. Supplemental oxygen should only be used if, despite effective ventilation, the heart rate does not increase above 100  beats  min(-1), or if oxygenation as indicated by pulse oximetry, remains unacceptably low. This review will focus on foetal physiology and pathophysiological aspects of neonatal adaptation and, thus, attempt to provide a solid basis for understanding the new resuscitation guidelines.
Thomas M Berger
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  European journal of anaesthesiology     Volume:  29     ISSN:  1365-2346     ISO Abbreviation:  Eur J Anaesthesiol     Publication Date:  2012 Aug 
Date Detail:
Created Date:  2012-07-12     Completed Date:  2012-11-21     Revised Date:  2013-08-27    
Medline Journal Info:
Nlm Unique ID:  8411711     Medline TA:  Eur J Anaesthesiol     Country:  England    
Other Details:
Languages:  eng     Pagination:  362-70     Citation Subset:  IM    
Neonatal and Paediatric Intensive Care Unit, Children's Hospital of Lucerne, Lucerne, Switzerland.
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MeSH Terms
Adaptation, Physiological
Anesthesiology / methods*,  standards
Cardiopulmonary Resuscitation* / standards
Fetus / physiopathology*
Heart Rate
Infant, Newborn
Infant, Newborn, Diseases / diagnosis,  etiology,  physiopathology,  therapy*
Intensive Care, Neonatal / methods*,  standards
Oxygen Inhalation Therapy
Practice Guidelines as Topic
Respiratory Mechanics
Treatment Outcome
Comment In:
Eur J Anaesthesiol. 2013 Aug;30(8):511   [PMID:  23511955 ]
Eur J Anaesthesiol. 2013 Aug;30(8):511   [PMID:  23736086 ]

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