• Resuscitation of preterm infants: delivery room interventions and their effect on outcomes.

      O'Donnell, Colm P F; Schmölzer, Georg M; Department of Neonatology, The National Maternity Hospital, Holles Street, Dublin 2, Ireland. (2012-12)
      Despite advances in neonatal care, the rate of oxygen dependence at 36 weeks' postmenstrual age or bronchopulmonary dysplasia has not fallen. Neonatologists are increasingly careful to apply ventilation strategies that are gentle to the lung in the neonatal intensive care unit. However, there has not been the same emphasis applying gentle ventilation strategies immediately after birth. A lung-protective strategy should start immediately after birth to establish a functional residual capacity, reduce volutrauma and atelectotrauma, facilitate gas exchange, and improve oxygenation during neonatal transition. This article discusses techniques and equipment recommended by international resuscitation guidelines during breathing assistance in the delivery room.
    • Turn and face the strange - ch..ch..ch..changes to neonatal resuscitation guidelines in the past decade.

      O'Donnell, Colm P F; The National Maternity Hospital, Our Lady's Children's Hospital, National Children's Research Centre, School of Medicine and Medical Science, University College Dublin, Dublin, Ireland. codonnell@nmh.ie (2012-09)
      Resuscitation of newborns has been described since ancient times and is among the most commonly performed emergency medical interventions. The International Liaison Committee on Resuscitation first made recommendations on resuscitation in newborns in 1999. Over the last decade, new research and careful review of the available evidence have resulted in substantial changes to these recommendations - in particular, regarding the assessment of colour, giving supplemental oxygen, suctioning infants born through meconium-stained liquor, confirming endotracheal tube position, the use of pulse oximetry, giving CPAP to premature infants, keeping preterm infants warm using polyethylene wrapping and cooling term infants with encephalopathy. This process has also highlighted the paucity of evidence to support much of the care given to infants in the delivery room and the need for research to refine our techniques.