Neonatal Resuscitation Research Priorities in Low- and Middle-Income Countries.

Vivek V Shukla,Somashekhar M Nimbalkar,Lavjay Butani

doi:10.1155/2021/6938772

Abstract

Several critical physiological changes occur during birth. Optimal and timely resuscitation is essential to avoid morbidity and mortality. The International Liaison Committee on Resuscitation (ILCOR) is a multinational committee that publishes evidence-based consensus and treatment recommendations for resuscitation in various scenarios including that for neonatal resuscitation. The majority of perinatal deaths occur in low- and middle-income countries (LMICs); however, there is limited research output from LMICs to generate evidence-based practice recommendations specific for LMICs. The current review identifies key areas of neonatal resuscitation-related research needed from LMICs to inform evidence-based resuscitation of neonates in LMICs.

Highlights

Extrauterine transition at birth and survival depends on several critical interlinked physiologic changes, including increase in systemic vascular resistance, decrease in pulmonary vascular resistance, closure of right to left shunts, alveolar fluid absorption and clearance, increase in metabolic demand, and endocrine changes [1,2,3,4]
The International Liaison Committee on Resuscitation (ILCOR) is a committee of 8 international resuscitation councils, the majority of which are from high-income countries, which publishes evidence-based consensus and treatment recommendations for neonatal resuscitation [12, 13]
The global perinatal and neonatal deaths are estimated to be 4 million per year, and of that, about 98% occur in low- and middle-income countries (LMICs) [15,16,17]

Summary

Introduction

Extrauterine transition at birth and survival depends on several critical interlinked physiologic changes, including increase in systemic vascular resistance, decrease in pulmonary vascular resistance, closure of right to left shunts, alveolar fluid absorption and clearance, increase in metabolic demand, and endocrine changes [1,2,3,4]. The extrauterine transition in term newborns occurs spontaneously in about 85% [5], 10% need stimulation [6], 5% need positive pressure ventilation, 2% need intubation, and 0.1% need chest compressions [7, 8]. Cardiopulmonary resuscitation is needed for a relatively small proportion of newborns [7]; the absolute number is high when seen in the context of the total number of births [9]. And appropriate resuscitation can prevent long-term morbidity and neonatal death [5, 10, 11]

Resuscitation Guidelines

Initial assessment and intervention

Conflicts of Interest