Abstract
Neonatal resuscitation is one of the most frequently performed procedures, and it is often successful if the ventilation applied is adequate. Over the last decade, interest in seeking objectivity in evaluating the infant’s condition at birth or the adequacy and effect of the interventions applied has markedly increased. Clinical parameters such as heart rate, color, and chest excursions are difficult to interpret and can be very subjective and subtle. The use of ECG, pulse oximetry, capnography, and respiratory function monitoring can add objectivity to the clinical assessment. These physiological parameters, with or without the combination of video recordings, can not only be used directly to guide care but also be used later for audit and teaching purposes. Further studies are needed to investigate whether this will improve the quality of delivery room management. In this narrative review, we will give an update of the current developments in monitoring neonatal resuscitation.
Highlights
During neonatal transition, lung aeration is pivotal for changes in respiratory and cardiovascular function required for survival [1, 2]
We will describe the current knowledge in monitoring neonatal resuscitation for direct feedback to guide the resuscitator with ongoing care and for feedback later, when it is used for auditing
Less clinical data are available for preterm infants, even a short period of hyperoxia in preterm infants at birth increases oxidative stress and inflammation, and preterm infants initially exposed to a high FiO2 have an increased risk for bronchopulmonary dysplasia [32]
Summary
Lung aeration is pivotal for changes in respiratory and cardiovascular function required for survival [1, 2]. Neonatal “resuscitation” comprises only the establishment of adequate ventilation [5, 6], which reflects the importance and vulnerability of infants as they transition to pulmonary gas exchange. Both experimental and clinical studies have demonstrated that even short periods of inappropriate respiratory support can have severe consequences, leading to lung and brain injury, especially in preterm infants [7,8,9]. Recording of physiological parameters and video images during neonatal resuscitation could improve quality as auditing is possible and assists in documentation, as it provides detailed information on resuscitation. We will describe the current knowledge in monitoring neonatal resuscitation for direct feedback to guide the resuscitator with ongoing care and for feedback later, when it is used for auditing
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