Tag Archives: Resuscitation

Cord milking and resuscitation, an alternative?

My recent posts about resuscitation with an intact cord were rapidly followed by a publication of another multicentre randomized controlled trial, this time a cluster randomized crossover trial, of cord milking in babies who needed intervention. (Katheria AC, et al. … Continue reading

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Resuscitation before clamping the cord, some physiologic considerations

Delaying cord clamping until respiration is well established is a physiologically pleasing approach, and avoids the dramatic decrease in left ventricular preload, simultaneously with an increase in afterload that occurs with early clamping. But does delaying clamping during positive pressure … Continue reading

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Resuscitation before clamping the cord?

Delayed cord clamping is now standard of care for all deliveries, at term or preterm. In term deliveries it leads to improved iron stores in the baby which difference persists during the first year of life. In very preterm infants … Continue reading

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Common interventions for common conditions; what do they have in common? A lack of evidence.

There are a number of problems in neonatal care for which good evidence is lacking, and an evidence based approach is therefore not really possible. Two recent reviews highlight this problem. The first is a systematic review of tactile stimulation … Continue reading

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Survival and outcomes for the extremely preterm. The NICHD network results continue to improve: Can we do even better?

A new publication from the NRN describes short term outcomes and care practices of babies from 22 to 28 weeks gestation born in recent years (2013 to 2018) and for those born in 2013-2016 results of evaluations of those followed … Continue reading

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How do we make decisions for the most immature babies, with their families?

Although babies under 25 weeks account for a tiny proportion of births, and a small proportion of NICU admissions, the importance of the question asked in the title can be seen by the ongoing number of publications, below are just … Continue reading

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Neonatal Updates

It’s a long time since I did one of these, but there were several publications that I thought warranted a quick comment. Abbey NV, et al. Electrocardiogram for heart rate evaluation during preterm resuscitation at birth: a randomized trial. Pediatr … Continue reading

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Delivering better CPAP in the delivery room, can we avoid intubation in the most immature babies?

Randomized trials have shown that trying to prevent intubation in the DR leads to less severe lung injury. The Cochrane review of prophylactic CPAP compared to immediate intubation included 3 trials (SUPPORT, COIN and DR Management study), that review found … Continue reading

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Oropharyngeal airways for resuscitation of the preterm? Throw them away!

When I saw the title of this new study I thought immediately this has to either be by Peter Davis or one or more of his disciples… former trainees, I mean. In fact it is both: Kamlin COF, et al. … Continue reading

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Oxygen for resuscitation of the very preterm

One of the paradoxes of neonatal respiratory control physiology is that hypoxia depresses respiration whilst hyperoxia stimulates breathing efforts. In fact it’s not such a paradox, prolonged hypoxia in adults decreases respiratory drive also. But could this be relevant in … Continue reading

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