Newaspects of neonatal resuscitation guidelines and their practical application].

L Vakrilova

Akusherstvo i ginekologii͡a 2013

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In this article we discuss the changes in the guidelines for newborn resuscitation, 2010, the International Liaison Committee on Resuscitation and their practical application at national level. The Resuscitation algorithm is simplified, the assessment of the need for resuscitation and progression to the next stage are based on heart rate and respiration only, that makes it easy for routine use and staff training. Routine suctioning of airways is not more recommended, even if meconium stained amniotic fluid is available endotracheal aspiration remains controversial. The most important changes concern the use of oxygen - there are clear recommendations to start resuscitation with air in term and low oxygen concentrations in preterm infants, monitoring the SpO2, so that the targeted SpO2 values for the first minutes of life are not exceeded. Some other aspects of newborn resuscitation and their practical application on local basis are discussed too: delayed cord clamping, therapeutic hypothermia, staff training. Controversial remain questions concerning initial resuscitation of extremely low gestational age newborns, such as some ethical issues.