Don't stop now? How long should resuscitation continue at birth in the absence of a detectable heartbeat?

Wilkinson, Dominic; Stenson, Ben J

doi:10.1136/archdischild-2015-308602

Cited by 8 publications

(3 citation statements)

References 17 publications

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“…Our findings are comparable with those reported by another centre where 13 infants asystolic within the first 10 postnatal minutes had a median time of UVC insertion and adrenaline administration of 12 min [ 9 ]. Recent studies have suggested that resuscitation might be continued beyond 10 min, even if no heart rate has been detected by then, as outcomes may not be as universally poor as previously thought [ 9 , 12 ].…”

Section: Discussionmentioning

confidence: 99%

Timing and documentation of key events in neonatal resuscitation

2018

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Only a minority of babies require extended resuscitation at birth. Resuscitations concerning babies who die or who survive with adverse outcomes are increasingly subject to medicolegal scrutiny. Our aim was to describe real-life timings of key resuscitation events observed in a historical series of newborns who required full resuscitation at birth. Twenty-seven babies born in our centre over a 10-year period had an Apgar score of 0 at 1 min and required full resuscitation. The median (95% confidence interval) postnatal age at achieving key events were commencing cardiac compressions, 2.0 (1.5–4.0) min; endotracheal intubation, 3.8 (2.0–6.0) min; umbilical venous catheterisation 9.0 (7.5–12.0) min; and administration of first adrenaline dose 10.0 (8.0–14.0) min.Conclusion: The wide range of timings presented from real-life cases may prove useful to clinicians involved in medical negligence claims and provide a baseline for quality improvements in resuscitation training. What is Known: • Only a minority of babies require extended resuscitation at birth; these cases are often subject to medicolegal interrogation • Timings of key resuscitation events are poorly described and documentation of resuscitation events is often lacking yet is open to medicolegal scrutiny What is New: • We present a wide range of real-life timings of key resuscitation events during the era of routine newborn life support training • These timings may prove useful to clinicians involved in medical negligence claims and provide a baseline for quality improvements in resuscitation training

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Section: Discussionmentioning

confidence: 99%

Timing and documentation of key events in neonatal resuscitation

2018

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“…1 En estos casos, si la FC permanece indetectable, se sugiere considerar detener la reanimación; sin embargo, la decisión de continuar o interrumpirla debe ser individualizada. 40 Las variables para tener en cuenta en esta decisión incluyen si la reanimación se consideró como óptima, la disponibilidad de atención neonatal avanzada, circunstancias específicas antes del parto (por ejemplo, conocer el momento del insulto asfíctico) y los deseos expresados por la familia.…”

Section: éTica Y Cuidados Del Final De La Vidaunclassified

Actualización en reanimación cardiopulmonar neonatal

2018

Arch Argent Pediat

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An update of the national recommendations on neonatal resuscitation elaborated by the Neonatal Resuscitation Work Area of the Fetal-Neonatal Studies Committee (CEFEN) of the Argentine Society of Pediatrics (SAP) is presented. These recommendations are original and in their elaboration, we have taken into account the best available evidence gathered by the International Liaison Committee on Resuscitation (ILCOR) as well as an exhaustive review of publications and discussions in the area to define controversial issues. Relevant concepts and major changes are described and analyzed. These recommendations refer to support for the transition at birth and to resuscitation of newborns, focusing on safety and effectiveness. We include a section on the importance of teamwork and its impact on results when we proceed with an adequate organization.

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“…Evidence of good outcome after this time period exists46 but has important limitations 47. There have been suggestions based on this limited evidence that a cut-off of 20 min should be used 48. This is hard to justify on the evidence available and, in any case, the current recommendations require that the decision be individualised and influenced by aetiology, the gestation of the baby, the potential reversibility of the situation, the availability of therapeutic hypothermia and the parents' previous expressed feelings about acceptable risk of morbidity.…”

Section: Ongoing Areas Of Uncertaintymentioning

confidence: 99%