1. Part 7: Neonatal Resuscitation
- Author
-
Wyllie, J., Perlman, J. M., Kattwinkel, J., Wyckoff, M. H., Aziz, K., Guinsburg, R., Kim, H. -S., Liley, H. G., Mildenhall, L., Simon, W. M., Szyld, E., Tamura, M., Velaphi, S., Boyle, D. W., Byrne, S., Colby, C., Capetta, Davis, Ersdal, H. L., Escobedo, M. B., Feng, Q., de Almeida, M. F., Halamek, L. P., Isayama, T., Kapadia, V. S., Lee, H. C., Mcgowan, M., Mcmillan, D. D., Niermeyer, S., O'Donnell, C. P. F., Rabi, Y., Ringer, S. A., Singhal, N., Stenson, B. J., Strand, M. L., Sugiura, T., Trevisanuto, D., Udaeta, E., Weiner, G. M., and Yeo, C. L.
- Subjects
Emergency Medical Services ,medicine.medical_treatment ,Diseases ,Heart Massage ,Incubators ,Pregnancy ,Neonatal Resuscitation Program ,Respiratory function ,Brain Damage ,Airway Management ,Chronic ,Evidence-Based Medicine ,Respiration ,Delivery room ,Survival Rate ,Observational Studies as Topic ,medicine.anatomical_structure ,Cardiopulmonary resuscitation ,Newborns ,Cardiopulmonary Resuscitation ,Humans ,Infant, Newborn ,Consensus ,Practice Guidelines as Topic ,Anesthesia ,Artificial ,Breathing ,Female ,Cardiology and Cardiovascular Medicine ,Delivery ,medicine.medical_specialty ,Monitoring ,Physiology (medical) ,medicine ,Physiologic ,Intensive care medicine ,Premature ,business.industry ,Delivery Rooms ,Brain Damage, Chronic ,Delivery, Obstetric ,Emergencies ,Heart Arrest ,Incubators, Infant ,Infant Care ,Infant, Premature ,Infant, Premature, Diseases ,Monitoring, Physiologic ,Pregnancy Complications ,Respiration, Artificial ,Infant ,Obstetric ,Newborn ,Pulmonary respiration ,Blood pressure ,Vascular resistance ,business ,Neonatal resuscitation - Abstract
Newborn Transition The transition from intrauterine to extrauterine life that occurs at the time of birth requires timely anatomic and physiologic adjustments to achieve the conversion from placental gas exchange to pulmonary respiration. This transition is brought about by initiation of air breathing and cessation of the placental circulation. Air breathing initiates marked relaxation of pulmonary vascular resistance, with considerable increase in pulmonary blood flow and increased return of now-well-oxygenated blood to the left atrium and left ventricle, as well as increased left ventricular output. Removal of the low-resistance placental circuit will increase systemic vascular resistance and blood pressure and reduce right-to-left shunting across the ductus arteriosus. The systemic organs must equally and quickly adjust to the dramatic increase in blood pressure and oxygen exposure. Similarly, intrauterine thermostability must be replaced by neonatal thermoregulation with its inherent increase in oxygen consumption. Approximately 85% of babies born at term will initiate spontaneous respirations within 10 to 30 seconds of birth, an additional 10% will respond during drying and stimulation, approximately 3% will initiate respirations after positive-pressure ventilation (PPV), 2% will be intubated to support respiratory function, and 0.1% will require chest compressions and/or epinephrine to achieve this transition.1–3 Although the vast majority of newborn infants do not require intervention to make these transitional changes, the large number of births worldwide means that many infants require some assistance to achieve cardiorespiratory stability each year. Newly born infants who are breathing or crying and have good tone immediately after birth must be dried and kept warm so as to avoid hypothermia. These actions can be provided with the baby lying on the mother’s chest and should not require separation of mother and baby. This does not preclude the need for clinical assessment of the baby. …
- Published
- 2015
- Full Text
- View/download PDF