Aim The International Liaison Committee on Resuscitation Neonatal Life Support Task Force undertook a scoping review of the literature to identify evidence relating to neonatal cardiopulmonary resuscitation.
Methods MEDLINE complete, EMBASE and Cochrane database of Systematic reviews were searched from inception to November 2021. Two authors screened titles and abstracts and full text reviewed. Studies were eligible for inclusion if they were peer-reviewed and assessed one of five aspects of chest compression in the newborn infant including: (1) heart rate thresholds to start chest compressions (CC), (2) compression to ventilation ratio (C:V ratio), (3) CC technique, (4) oxygen use during CC and 5) feedback devices to optimise CC.
Results Seventy-four studies were included (n=46 simulation, n=24 animal and n=4 clinical studies); 22/74 were related to compression to ventilation ratios, 29/74 examined optimal technique to perform CC, 7/74 examined oxygen delivery and 15/74 described feedback devices during neonatal CC.
Conclusion There were very few clinical studies and mostly manikin and animal studies. The findings either reinforced or were insufficient to change previous recommendations which included to start CC if heart rate remains <60/min despite adequate ventilation, using a 3:1 C:V ratio, the two-thumb encircling technique and 100% oxygen during CC.
- Intensive Care Units, Neonatal
Data availability statement
All data relevant to the study are included in the article or uploaded as supplementary information.
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SR and MB are joint first authors.
Collaborators Thank you also to the Members of the International Liaison Committee on Resuscitation Neonatal Life Support Task Force for reading the manuscript and providing contributions: Daniela T Costa-Nobre, MD MHS PhD; Mandira Daripa Kawakami, MD PhD; Peter G Davis, MBBS MD; Walid El-Naggar, MD; Jorge G Fabres, MD, MSPH; Joe Fawke, MBChB; Elizabeth E Foglia, MD; Ruth Guinsburg, MD PhD; Tetsuya Isayama, MD, PhD; Henry C Lee, MD; Helen G Liley, MBChBR; John Madar, MBBS; Christopher J D McKinlay, MBChB PhD DipProfEthics; Firdose L Nakwa, MBChB MMed (Paeds); Jeffrey M Perlman, MBChB; Jack Yacov Rabi, MD; Mario Rüdiger, MD PhD; Takahiro Sugiura, MD PhD; Daniele Trevisanuto, MD; Gary M Weiner, MD; Jonathan P Wyllie, MBChB.
Contributors Scoping review conception: MHW, GMS. Data extraction and Screening articles: SR, MB, GMS. Drafting of the manuscript: SR, MB. Critical revision of the manuscript: SR, MB, MHW, GMS. Final approval of the manuscript: SR, MB, MHW, GMS.
Funding The International Liaison Committee on Resuscitation provided support that included access to software platforms and videoconferencing.
Competing interests SR has no conflicts of interest. MB has received funding from The Laerdal Foundation for Acute Medicine to study various aspects of chest compression. MB has published articles which were included in the scoping review. MHW has published several articles, which were included in the scoping review. MHW (Past Member and Past Co-Chair) and GMS (Member) of the Neonatal Taskforce within the International Liaison Committee on Resuscitation, which updated and publishes resuscitation guidelines. GMS has received funding from the Heart and Stroke Foundation Alberta, Heart and Stroke Foundation Canada, Canadian Institutes of Health Research, Neonatal Resuscitation Program Canada, The Laerdal Foundation for Acute Medicine and National Health and Medical Research Council to study various aspects of chest compression. GMS has published several articles, which were included in the scoping review.
Provenance and peer review Not commissioned; externally peer reviewed.
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