Archives of Disease in Childhood - Fetal and Neonatal Edition 2008;93:F334-F336
LEADING ARTICLES
Advances in neonatal resuscitation: supporting transition
Neonatal Services, Royal Women’s Hospital, Carlton, Victoria 3053, Australia
C Morley, Neonatal Services, Royal Women’s Hospital, Carlton, Victoria 3053, Australia; colin.morley@rwh.org.au
Accepted 15 April 2008
| The first 150 words of the full text of this article appear below. |
Although neonatologists use the term resuscitation we rarely practise resuscitation as the adult doctors understand it. An adult who collapses lifeless needs very urgent chest compressions, cardioversion and ventilation. Such an episode is very uncommon in neonates. Wyckoff et al suggests that it probably occurs in less than 1:2000 deliveries.1 Newborn infants who do not breathe sufficiently need gentle assistance to make the transition from placental to pulmonary gas exchange.
Apnoea and bradycardia after birth are caused by relative hypoxia of the brain stem and myocardium. At birth the lungs are not aerated and filled with lung liquid. If infants do not breathe adequately they need assistance aerating their lungs and forming a functional residual capacity (FRC). Oxygenation of the myocardium then improves and the heart rate and blood pressure rapidly increase. Shortly thereafter the brain stem recovers and breathing starts. Most apnoeic newborn infants respond well to effective aeration
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