Open AccessResuscitation of extremely preterm infants - controversies and current evidence
Author(s) -
Prashant Patel,
Jayanta Banerjee,
Sunit Godambe
Publication year - 2016
Publication title -
world journal of clinical pediatrics
Language(s) - English
Resource type - Journals
ISSN - 2219-2808
DOI - 10.5409/wjcp.v5.i2.151
Subject(s) - medicine , gestational age , resuscitation , cord clamping , pediatrics , intensive care medicine , cardiorespiratory fitness , neonatal resuscitation , pregnancy , cord , anesthesia , surgery , genetics , biology
Despite significant advances in perinatal medicine, the management of extremely preterm infants in the delivery room remains a challenge. There is an increasing evidence for improved outcomes regarding the resuscitation and stabilisation of extremely preterm infants but there is a lack of evidence in the periviable (gestational age 23-25 wk) preterm subgroup. Presence of an experienced team during the delivery of extremely preterm infant to improve outcome is reviewed. Adaptation from foetal to neonatal cardiorespiratory haemodynamics is dependent on establishing an optimal functional residual capacity in the extremely preterm infants, thus enabling adequate gas exchange. There is sufficient evidence for a gentle approach to stabilisation of these fragile infants in the delivery room. Evidence for antenatal steroids especially in the periviable infants, delayed cord clamping, strategies to establish optimal functional residual capacity, importance of temperature control and oxygenation in delivery room in extremely premature infants is reviewed in this article.