AIM: Standard resuscitation guidelines are based on data from a range of gestational ages. We sought to evaluate the effectiveness of our delivery room resuscitation protocol across a range of gestational ages in preterm infants born at <29 weeks. METHODS: We performed an observational study of prospectively collected video recordings of 73 preterm infants. The percentage of bradycardic patients, time to reach target oxygen saturation and the extent of all interventions were compared between three gestational age groups: 22-24 weeks (n = 22), 25-26 weeks (n = 27) and 27-28 weeks (n = 24). RESULTS: Although the same resuscitation protocol was followed for all infants, bradycardic infants born <25 weeks responded poorly and required significantly longer to reach oxygen saturation targets of >70%, >80% and >90% (p < 0.03). They required significantly more interventions and had higher rate of death (p < 0.05) and severe intraventricular haemorrhage (p < 0.03). Significantly lower heart rate and oxygen saturation values were found in infants with intraventricular haemorrhage. CONCLUSION: Current recommendations for resuscitation may fail to achieve timely lung aeration in infants born at the borderline of viability, leading to higher mortality and morbidity. Sustained inflation and delayed cord clamping may be effective alternatives.
- MeSH
- Gestational Age MeSH
- Humans MeSH
- Infant, Extremely Premature * MeSH
- Infant, Newborn MeSH
- Prospective Studies MeSH
- Resuscitation statistics & numerical data MeSH
- Check Tag
- Humans MeSH
- Male MeSH
- Infant, Newborn MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Observational Study MeSH
- Research Support, Non-U.S. Gov't MeSH
- Comparative Study MeSH
- MeSH
- Humans MeSH
- Resuscitation methods nursing statistics & numerical data MeSH
- Emergency Medical Services * methods organization & administration utilization MeSH
- Military Medicine * MeSH
- Out-of-Hospital Cardiac Arrest * diagnosis mortality prevention & control MeSH
- Check Tag
- Humans MeSH
- Geographicals
- Czech Republic MeSH
- MeSH
- Anesthesiology * statistics & numerical data MeSH
- Length of Stay statistics & numerical data MeSH
- Child MeSH
- Adult MeSH
- Physicians statistics & numerical data MeSH
- Humans MeSH
- Adolescent MeSH
- Young Adult MeSH
- Mortality * MeSH
- Hospital Departments statistics & numerical data MeSH
- Bed Occupancy statistics & numerical data MeSH
- Child, Preschool MeSH
- Resuscitation * statistics & numerical data MeSH
- Aged MeSH
- Nurses statistics & numerical data MeSH
- Check Tag
- Child MeSH
- Adult MeSH
- Humans MeSH
- Adolescent MeSH
- Young Adult MeSH
- Child, Preschool MeSH
- Aged MeSH
- Geographicals
- Czech Republic MeSH
- MeSH
- Anesthesiology * history methods statistics & numerical data MeSH
- Outcome Assessment, Health Care history statistics & numerical data utilization MeSH
- Critical Care * history methods statistics & numerical data MeSH
- Resuscitation * history methods statistics & numerical data MeSH
- Societies, Medical trends MeSH
- Publication type
- Introductory Journal Article MeSH
- Keywords
- statistické údaje 2010, Pracovníci, MIT (Mors in tabula), TISS kategorie, APACHE II, umělá ventilace, ošetřovací doba KAR/ARO, diagnostické rozdělení, zotavení, ambulance léčby bolesti, anesteziologická ambulance,
- MeSH
- Anesthesiology statistics & numerical data trends MeSH
- Child MeSH
- Intensive Care Units statistics & numerical data trends MeSH
- Humans MeSH
- Mortality MeSH
- Resuscitation statistics & numerical data trends MeSH
- Aged, 80 and over MeSH
- Aged MeSH
- Check Tag
- Child MeSH
- Humans MeSH
- Aged, 80 and over MeSH
- Aged MeSH
- Keywords
- Statistické údaje 2009, Personální obsazení, MIT (Mors in tabula), TISS kategorie, APACHE II, Umělá ventilace, Ošetřovací doba KAR/ARO, Diagnostické rozdělení, Diagnostický profil na resuscitačních lůžkách, Zotavení, Ambulance léčby bolesti,
- MeSH
- Anesthesiology statistics & numerical data MeSH
- Intensive Care Units economics manpower statistics & numerical data MeSH
- Humans MeSH
- Mortality MeSH
- Resuscitation statistics & numerical data MeSH
- Check Tag
- Humans MeSH
- MeSH
- Anesthesia statistics & numerical data utilization MeSH
- Anesthesiology statistics & numerical data MeSH
- Child MeSH
- Data Interpretation, Statistical MeSH
- Humans MeSH
- Mortality MeSH
- Resuscitation methods statistics & numerical data utilization MeSH
- Aged statistics & numerical data MeSH
- Health Workforce statistics & numerical data utilization MeSH
- Check Tag
- Child MeSH
- Humans MeSH
- Aged statistics & numerical data MeSH
- Geographicals
- Czech Republic MeSH
