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Premature infants born at <25 weeks of gestation may be compromised by currently recommended resuscitation techniques
Author(s) -
Lamberska Tereza,
Luksova Marketa,
Smisek Jan,
Vankova Jana,
Plavka Richard
Publication year - 2016
Publication title -
acta paediatrica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.772
H-Index - 115
eISSN - 1651-2227
pISSN - 0803-5253
DOI - 10.1111/apa.13178
Subject(s) - medicine , resuscitation , gestational age , gestation , neonatology , oxygen saturation , anesthesia , intraventricular hemorrhage , asphyxia , pediatrics , pregnancy , oxygen , chemistry , organic chemistry , biology , genetics
Aim Standard resuscitation guidelines are based on data from a range of gestational ages. We sought to evaluate the effectiveness of our delivery room resuscitation protocol across a range of gestational ages in preterm infants born at <29 weeks. Methods We performed an observational study of prospectively collected video recordings of 73 preterm infants. The percentage of bradycardic patients, time to reach target oxygen saturation and the extent of all interventions were compared between three gestational age groups: 22–24 weeks (n = 22), 25–26 weeks (n = 27) and 27–28 weeks (n = 24). Results Although the same resuscitation protocol was followed for all infants, bradycardic infants born <25 weeks responded poorly and required significantly longer to reach oxygen saturation targets of >70%, >80% and >90% (p < 0.03). They required significantly more interventions and had higher rate of death (p < 0.05) and severe intraventricular haemorrhage (p < 0.03). Significantly lower heart rate and oxygen saturation values were found in infants with intraventricular haemorrhage. Conclusion Current recommendations for resuscitation may fail to achieve timely lung aeration in infants born at the borderline of viability, leading to higher mortality and morbidity. Sustained inflation and delayed cord clamping may be effective alternatives.