Document Detail


'Resuscitation' of extremely preterm and/or low-birth-weight infants - time to 'call it'?
MedLine Citation:
PMID:  18525213     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Since ancient times, various methods have been used to revive apparently stillborn infants; many were of dubious efficacy and had the potential to cause harm. Based largely on studies of acutely asphyxiated term animal models, clinical assessment and positive pressure ventilation have become the cornerstones of neonatal resuscitation over the last 40 years. Over the last 25 years, care of extremely preterm infants in the delivery room has evolved from a policy of indifference to one of increasingly aggressive support. The survival of these infants has improved considerably in recent years; this has not, however, necessarily been due to more aggressive resuscitation. Urban myths have evolved that all extremely preterm infants died before they were intubated, and that all such infants need to immediately intubated or they will quickly die. This has never been true. Clinical assessment of infants at birth is subjective. Also, many techniques used to support preterm infants at birth have not been well studied and there is evidence that they may be harmful. It may thus be argued that many of our well-intentioned resuscitation interventions are of dubious efficacy and have the potential to cause harm. 'Resuscitation' is an emotive term which means 'restoration of life'. Death, thankfully, is a rare presentation in the delivery room. Therefore, concerning neonatal 'resuscitation', it is time to 'call it' something else. This will allow us to dispassionately distinguish preterm infants who are dead, or nearly dead, from those who are merely at high risk of parenchymal lung disease. We may then be able to refine our interventions and determine what methods of support benefit these infants most.
Authors:
Colm P F O'Donnell
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Publication Detail:
Type:  Journal Article; Review     Date:  2008-06-05
Journal Detail:
Title:  Neonatology     Volume:  93     ISSN:  1661-7819     ISO Abbreviation:  -     Publication Date:  2008  
Date Detail:
Created Date:  2008-06-05     Completed Date:  2008-08-29     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101286577     Medline TA:  Neonatology     Country:  Switzerland    
Other Details:
Languages:  eng     Pagination:  295-301     Citation Subset:  IM    
Copyright Information:
(c) 2008 S. Karger AG, Basel.
Affiliation:
The National Maternity Hospital and Our Lady's Children's Hospital, Dublin, Ireland. codonnell@nmh.ie
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MeSH Terms
Descriptor/Qualifier:
Bronchopulmonary Dysplasia / etiology,  prevention & control
Cardiopulmonary Resuscitation / adverse effects,  methods*,  standards
Delivery Rooms
Guidelines as Topic
Humans
Infant, Extremely Low Birth Weight*
Infant, Newborn
Infant, Premature*
Infant, Very Low Birth Weight*
Respiration, Artificial* / adverse effects

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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