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Volume resuscitation (VR) for the treatment of newborn shock is a rare but potentially lifesaving intervention. Conducting clinical studies to assess the effectiveness of VR in the delivery room during newborn stabilization is challenging. We review the available literature and current management guidelines to determine which infants will benefit from VR, the frequency of VR, and the choice of agents used. In addition, the potential role for placental transfusion in the prevention of newborn shock is explored., (© 2017 S. Karger AG, Basel.)

Aim: To examine user ability and preference in performing bag-mask ventilation (BMV) with four different configurations of infant mannequins., Methods: Participants provided a 30-second period of BMV to a Resusci Baby mannequin (RB), NeoNatalie mannequin (NN), NN filled with air (NNA), NN filled with water (NNW) and NN filled with 50% air and 50% water mix (NNAW). Participants rated the fidelity of each configuration., Results: Of the 20 participants, 65% rated NNW as having a high level of fidelity (HLF) 'to hold' (50% for NNAW, 10% for RB and 0% for NNA) (p < 0.001). Half rated NNAW as having a HLF in 'tone' (40% for NNW, 20% for RB and 5% for NNA) (p = 0.008). About 45% of participants rated NNAW as having a HLF in 'appearance' (45% for the RB, 20% for NNA and 15% for NNW) (p = 0.035). About 35% of participants rated NNAW as having a HLF in how it 'felt to touch' (30% for NNW, 15% for RB and 10% for NNA) (p = 0.008). Half of participants rated NNAW as having a HLF in terms of 'weight' (45% for NNW, 40% for RB and 0% for NNA) (p = 0.003). Participants delivered the greatest number of effective ventilations to the NNW mannequin., Conclusion: The NNW and NNAW configurations had the highest fidelity and had the highest percentage of effective ventilations delivered., (©2015 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.)

Background: Substantial health care resources are expended on standardised formal neonatal resuscitation training (SFNRT) programmes, but their effectiveness has not been proven., Objectives: To determine whether SFNRT programmes reduce neonatal mortality and morbidity, improve acquisition and retention of knowledge and skills, or change teamwork and resuscitation behaviour., Methods: We searched CENTRAL, MEDLINE, PREMEDLINE, EMBASE, CINAHL, Web of Science and the Oxford Database of Perinatal Trials, ongoing trials and conference proceedings in April 2015, and included randomised or quasi-randomised trials that reported at least one of our specified outcomes., Results: SFNRT in low- and middle-income countries decreased early neonatal mortality [risk ratio (RR) 0.85 (95% CI 0.75-0.96)]; the number needed to treat for benefit [227 (95% CI 122-1,667; 3 studies, 66,162 participants, moderate-quality evidence)], and 28-day mortality [RR 0.55 (95% CI 0.33-0.91); 1 study, 3,355 participants, low-quality evidence]. Decreasing trends were noted for late neonatal mortality [RR 0.47 (95% CI 0.20-1.11)] and perinatal mortality [RR 0.94 (95% CI 0.87-1.00)], but there were no differences in fresh stillbirths [RR 1.05 (95% CI 0.93-1.20)]. Teamwork training with simulation increased the frequency of teamwork behaviour [mean difference (MD) 2.41 (95% CI 1.72-3.11)] and decreased resuscitation duration [MD -149.54 (95% CI -214.73 to -84.34); low-quality evidence, 2 studies, 130 participants]., Conclusions: SFNRT in low- and middle-income countries reduces early neonatal mortality, but its effects on birth asphyxia and neurodevelopmental outcomes remain uncertain. Follow-up studies suggest normal neurodevelopment in resuscitation survivors., (© 2016 S. Karger AG, Basel.)