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What is new in the European and UK neonatal resuscitation guidance?
  1. Jonathan Wyllie1,
  2. Sean Ainsworth2
  1. 1Department of Neonatology, The James Cook University Hospital, Middlesbrough, UK
  2. 2Paediatric and Neonatal Division Planned Care Directorate, Victoria Hospital, Kirkcaldy, UK
  1. Correspondence to Dr Jonathan Wyllie, Department of Neonatology, The James Cook University Hospital, Marton Road, Middlesbrough TS4 3BW, UK; jonathan.wyllie{at}stees.nhs.uk

https://doi.org/10.1136/archdischild-2015-309472

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    New European Resuscitation Council (ERC) and UK guidelines for ‘Resuscitation and support of transition of babies at birth’ were published simultaneously in October 2015.1 Both are based on the evidence derived from a critical evaluation of relevant scientific publications over the preceding 5 years organised and coordinated by the International Liaison Committee on Resuscitation (ILCOR).2 ,3 Where there was no new evidence the guidelines may reflect those evidence evaluations carried out in 20054 or 20105 and incorporate published papers not evaluated by the ILCOR.

    This article summarises both the process and the main areas of change (box 1), which, for the most part, are refinements of previous guidelines. It will also briefly discuss ongoing areas of controversy where evidence was insufficient to lead to inclusion.

    Box 1

    Main areas of change in the 2015 European Resuscitation Council and UK newborn resuscitation guidelines

    The title of the guidelines has been changed from Resuscitation at Birth to Resuscitation and support of transition at birth to reflect an emphasis on supporting transition to air breathing rather than resuscitation.

    A delay in the clamping of the cord of at least 1 min from the time of complete delivery of the baby is recommended for all babies when possible.

    The newborn baby's temperature should be maintained in the normal range (36.5°C to 37.5°C) unless it is being considered for therapeutic hypothermia. Active steps should be taken to achieve this.

    An accurate assessment of heart rate can be made using ECG or pulse oximetry.

    Tracheal intubation and suction is no longer routine for any baby born through meconium-stained liquor. Instead the emphasis should be on providing appropriate resuscitative manoeuvres as soon as possible and only intubate the trachea for suction in those infants whose airway is blocked.

    Begin the resuscitation of term babies …

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    Footnotes

    • Contributors JW and SA had joint responsibility writing the first draft, editing the manuscript and approval of the final draft.

    • Competing interests JW is an unpaid co-chair of the ILCOR newborn task force and a member of the European Resuscitation Council developing guidelines for newborn resuscitation, both JW and SA are unpaid members of the Newborn Life Support Subcommittee of the Resuscitation Council (UK) developing the UK guidelines for newborn resuscitation.

    • Provenance and peer review Commissioned; externally peer reviewed.