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Resuscitation of the newly born infant : an advisory statement from the Pediatric Working Group of the International Liaison Committee on Resuscitation

Identifieur interne : 006C65 ( PascalFrancis/Curation ); précédent : 006C64; suivant : 006C66

Resuscitation of the newly born infant : an advisory statement from the Pediatric Working Group of the International Liaison Committee on Resuscitation

Auteurs : J. Kattwinkel [États-Unis] ; S. Niermeyer [États-Unis] ; V. Nadkarni [États-Unis] ; J. Tibballs [Australie] ; B. Phillips [France] ; D. Zideman [France] ; P. Van Reempts [France] ; M. Osmond [Canada]

Source :

RBID : Pascal:99-0235202

Descripteurs français

English descriptors

Abstract

The International Liaison Committee on Resuscitation (ILCOR), with representation from North America, Europe, Australia, New Zealand, Africa, and South America, was formed in 1992 to provide a forum for liaison between resuscitation organizations in the developed world. This consensus document on resuscitation extends previously published ILCOR advisory statements on resuscitation to address the unique and changing physiology of the newly born infant within the first few hours following birth and the techniques for providing advanced life support. After careful review of the international resuscitation literature and after discussion of key and controversial issues, consensus was reached on almost all aspects of neonatal resuscitation, and areas of controversy and high priority for additional research were delineated. Consensus on resuscitation for the newly born infant included the following principles. (i) Personnel trained in the basic skills of resuscitation should be in attendance at every delivery. A minority (fewer than 10%) of newly born infants require active resuscitative interventions to establish a vigorous cry and regular respirations, maintain a heart rate greater than 100 beats per minute (bpm), and maintain good color and tone. (ii) When meconium is present in the amniotic fluid, it should be suctioned from the hypopharynx on delivery of the head. If the meconium-stained newly born infant has absent or depressed respirations, heart rate, or muscle tone, residual meconium should be suctioned from the trachea. (ii) Attention to ventilation should be of primary concern. Assisted ventilation with attention to oxygen delivery, inspiratory time, and effectiveness judged by chest rise should be provided if stimulation does not achieve prompt onset of spontaneous respirations and/or the heart rate is less than 100 bpm. (iv) Chest compressions should be provided if the heart rate is absent or remains less than 60 bpm despite adequate assisted ventilation for 30 s. Chest compressions should be coordinated with ventilations at a ratio of 3:1 and a rate of 120 events' per minute to achieve approximately 90 compressions and 30 rescue breaths per minute. (v) Epinephrine should be administered intravenously or intratracheally if the heart rate remains less than 60 bpm despite 30 s of effective assisted ventilation and chest compression circulation. Common or controversial medications (epinephrine, volume expansion, naloxone, bicarbonate), special resuscitation circumstances affecting care of the newly born, continuing care of the newly born after resuscitation, and ethical considerations for initiation and discontinuation of resuscitation are discussed. There was agreement that insufficient data exist to recommend changes to current guidelines regarding the use of 21% versus 100% oxygen, neuroprotective interventions such as cerebral hypothermia, use of a laryngeal mask versus endotracheal tube, and use of high-dose epinephrine. Areas of controversy are identified, as is the need for additional research to improve the scientific justification of each component of current and future resuscitation guidelines.
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<div type="abstract" xml:lang="en">The International Liaison Committee on Resuscitation (ILCOR), with representation from North America, Europe, Australia, New Zealand, Africa, and South America, was formed in 1992 to provide a forum for liaison between resuscitation organizations in the developed world. This consensus document on resuscitation extends previously published ILCOR advisory statements on resuscitation to address the unique and changing physiology of the newly born infant within the first few hours following birth and the techniques for providing advanced life support. After careful review of the international resuscitation literature and after discussion of key and controversial issues, consensus was reached on almost all aspects of neonatal resuscitation, and areas of controversy and high priority for additional research were delineated. Consensus on resuscitation for the newly born infant included the following principles. (i) Personnel trained in the basic skills of resuscitation should be in attendance at every delivery. A minority (fewer than 10%) of newly born infants require active resuscitative interventions to establish a vigorous cry and regular respirations, maintain a heart rate greater than 100 beats per minute (bpm), and maintain good color and tone. (ii) When meconium is present in the amniotic fluid, it should be suctioned from the hypopharynx on delivery of the head. If the meconium-stained newly born infant has absent or depressed respirations, heart rate, or muscle tone, residual meconium should be suctioned from the trachea. (ii) Attention to ventilation should be of primary concern. Assisted ventilation with attention to oxygen delivery, inspiratory time, and effectiveness judged by chest rise should be provided if stimulation does not achieve prompt onset of spontaneous respirations and/or the heart rate is less than 100 bpm. (iv) Chest compressions should be provided if the heart rate is absent or remains less than 60 bpm despite adequate assisted ventilation for 30 s. Chest compressions should be coordinated with ventilations at a ratio of 3:1 and a rate of 120 events' per minute to achieve approximately 90 compressions and 30 rescue breaths per minute. (v) Epinephrine should be administered intravenously or intratracheally if the heart rate remains less than 60 bpm despite 30 s of effective assisted ventilation and chest compression circulation. Common or controversial medications (epinephrine, volume expansion, naloxone, bicarbonate), special resuscitation circumstances affecting care of the newly born, continuing care of the newly born after resuscitation, and ethical considerations for initiation and discontinuation of resuscitation are discussed. There was agreement that insufficient data exist to recommend changes to current guidelines regarding the use of 21% versus 100% oxygen, neuroprotective interventions such as cerebral hypothermia, use of a laryngeal mask versus endotracheal tube, and use of high-dose epinephrine. Areas of controversy are identified, as is the need for additional research to improve the scientific justification of each component of current and future resuscitation guidelines.</div>
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<fA08 i1="01" i2="1" l="ENG">
<s1>Resuscitation of the newly born infant : an advisory statement from the Pediatric Working Group of the International Liaison Committee on Resuscitation</s1>
</fA08>
<fA11 i1="01" i2="1">
<s1>KATTWINKEL (J.)</s1>
</fA11>
<fA11 i1="02" i2="1">
<s1>NIERMEYER (S.)</s1>
</fA11>
<fA11 i1="03" i2="1">
<s1>NADKARNI (V.)</s1>
</fA11>
<fA11 i1="04" i2="1">
<s1>TIBBALLS (J.)</s1>
</fA11>
<fA11 i1="05" i2="1">
<s1>PHILLIPS (B.)</s1>
</fA11>
<fA11 i1="06" i2="1">
<s1>ZIDEMAN (D.)</s1>
</fA11>
<fA11 i1="07" i2="1">
<s1>VAN REEMPTS (P.)</s1>
</fA11>
<fA11 i1="08" i2="1">
<s1>OSMOND (M.)</s1>
</fA11>
<fA14 i1="01">
<s1>American Academy of Pediatrics</s1>
<s2>Elk Grove Village, IL</s2>
<s3>USA</s3>
<sZ>1 aut.</sZ>
<sZ>2 aut.</sZ>
<sZ>3 aut.</sZ>
</fA14>
<fA14 i1="02">
<s1>Neonatal Resuscitation Program</s1>
<s2>Elk Grove Village, IL</s2>
<s3>USA</s3>
<sZ>1 aut.</sZ>
</fA14>
<fA14 i1="03">
<s1>American Heart Association</s1>
<s2>Dallas</s2>
<s3>USA</s3>
<sZ>2 aut.</sZ>
<sZ>3 aut.</sZ>
</fA14>
<fA14 i1="04">
<s1>Australian Resuscitation Council</s1>
<s2>Sydney</s2>
<s3>AUS</s3>
<sZ>4 aut.</sZ>
</fA14>
<fA14 i1="05">
<s1>European Resuscitation Council</s1>
<s2>Paris</s2>
<s3>FRA</s3>
<sZ>5 aut.</sZ>
<sZ>6 aut.</sZ>
<sZ>7 aut.</sZ>
</fA14>
<fA14 i1="06">
<s1>Heart and Stroke Foundation of Canada</s1>
<s2>Toronto</s2>
<s3>CAN</s3>
<sZ>8 aut.</sZ>
</fA14>
<fA20>
<s1>71-88</s1>
</fA20>
<fA21>
<s1>1999</s1>
</fA21>
<fA23 i1="01">
<s0>ENG</s0>
</fA23>
<fA43 i1="01">
<s1>INIST</s1>
<s2>21284</s2>
<s5>354000083586250010</s5>
</fA43>
<fA44>
<s0>0000</s0>
<s1>© 1999 INIST-CNRS. All rights reserved.</s1>
</fA44>
<fA45>
<s0>85 ref.</s0>
</fA45>
<fA47 i1="01" i2="1">
<s0>99-0235202</s0>
</fA47>
<fA60>
<s1>P</s1>
</fA60>
<fA61>
<s0>A</s0>
</fA61>
<fA64 i1="01" i2="1">
<s0>Resuscitation</s0>
</fA64>
<fA66 i1="01">
<s0>IRL</s0>
</fA66>
<fC01 i1="01" l="ENG">
<s0>The International Liaison Committee on Resuscitation (ILCOR), with representation from North America, Europe, Australia, New Zealand, Africa, and South America, was formed in 1992 to provide a forum for liaison between resuscitation organizations in the developed world. This consensus document on resuscitation extends previously published ILCOR advisory statements on resuscitation to address the unique and changing physiology of the newly born infant within the first few hours following birth and the techniques for providing advanced life support. After careful review of the international resuscitation literature and after discussion of key and controversial issues, consensus was reached on almost all aspects of neonatal resuscitation, and areas of controversy and high priority for additional research were delineated. Consensus on resuscitation for the newly born infant included the following principles. (i) Personnel trained in the basic skills of resuscitation should be in attendance at every delivery. A minority (fewer than 10%) of newly born infants require active resuscitative interventions to establish a vigorous cry and regular respirations, maintain a heart rate greater than 100 beats per minute (bpm), and maintain good color and tone. (ii) When meconium is present in the amniotic fluid, it should be suctioned from the hypopharynx on delivery of the head. If the meconium-stained newly born infant has absent or depressed respirations, heart rate, or muscle tone, residual meconium should be suctioned from the trachea. (ii) Attention to ventilation should be of primary concern. Assisted ventilation with attention to oxygen delivery, inspiratory time, and effectiveness judged by chest rise should be provided if stimulation does not achieve prompt onset of spontaneous respirations and/or the heart rate is less than 100 bpm. (iv) Chest compressions should be provided if the heart rate is absent or remains less than 60 bpm despite adequate assisted ventilation for 30 s. Chest compressions should be coordinated with ventilations at a ratio of 3:1 and a rate of 120 events' per minute to achieve approximately 90 compressions and 30 rescue breaths per minute. (v) Epinephrine should be administered intravenously or intratracheally if the heart rate remains less than 60 bpm despite 30 s of effective assisted ventilation and chest compression circulation. Common or controversial medications (epinephrine, volume expansion, naloxone, bicarbonate), special resuscitation circumstances affecting care of the newly born, continuing care of the newly born after resuscitation, and ethical considerations for initiation and discontinuation of resuscitation are discussed. There was agreement that insufficient data exist to recommend changes to current guidelines regarding the use of 21% versus 100% oxygen, neuroprotective interventions such as cerebral hypothermia, use of a laryngeal mask versus endotracheal tube, and use of high-dose epinephrine. Areas of controversy are identified, as is the need for additional research to improve the scientific justification of each component of current and future resuscitation guidelines.</s0>
</fC01>
<fC02 i1="01" i2="X">
<s0>002B27B11</s0>
</fC02>
<fC03 i1="01" i2="X" l="FRE">
<s0>Réanimation</s0>
<s5>01</s5>
</fC03>
<fC03 i1="01" i2="X" l="ENG">
<s0>Resuscitation</s0>
<s5>01</s5>
</fC03>
<fC03 i1="01" i2="X" l="SPA">
<s0>Reanimación</s0>
<s5>01</s5>
</fC03>
<fC03 i1="02" i2="X" l="FRE">
<s0>Cardiopulmonaire</s0>
<s5>02</s5>
</fC03>
<fC03 i1="02" i2="X" l="ENG">
<s0>Cardiopulmonary</s0>
<s5>02</s5>
</fC03>
<fC03 i1="02" i2="X" l="SPA">
<s0>Cardiopulmonar</s0>
<s5>02</s5>
</fC03>
<fC03 i1="03" i2="X" l="FRE">
<s0>Néonatologie</s0>
<s5>04</s5>
</fC03>
<fC03 i1="03" i2="X" l="ENG">
<s0>Neonatology</s0>
<s5>04</s5>
</fC03>
<fC03 i1="03" i2="X" l="SPA">
<s0>Neonatología</s0>
<s5>04</s5>
</fC03>
<fC03 i1="04" i2="X" l="FRE">
<s0>Modalité traitement</s0>
<s5>07</s5>
</fC03>
<fC03 i1="04" i2="X" l="ENG">
<s0>Application method</s0>
<s5>07</s5>
</fC03>
<fC03 i1="04" i2="X" l="SPA">
<s0>Modalidad tratamiento</s0>
<s5>07</s5>
</fC03>
<fC03 i1="05" i2="X" l="FRE">
<s0>Soin intensif</s0>
<s5>16</s5>
</fC03>
<fC03 i1="05" i2="X" l="ENG">
<s0>Intensive care</s0>
<s5>16</s5>
</fC03>
<fC03 i1="05" i2="X" l="SPA">
<s0>Cuidado intensivo</s0>
<s5>16</s5>
</fC03>
<fC03 i1="06" i2="X" l="FRE">
<s0>Technique</s0>
<s5>17</s5>
</fC03>
<fC03 i1="06" i2="X" l="ENG">
<s0>Technique</s0>
<s5>17</s5>
</fC03>
<fC03 i1="06" i2="X" l="SPA">
<s0>Técnica</s0>
<s5>17</s5>
</fC03>
<fC03 i1="07" i2="X" l="FRE">
<s0>Recommandation</s0>
<s5>18</s5>
</fC03>
<fC03 i1="07" i2="X" l="ENG">
<s0>Recommendation</s0>
<s5>18</s5>
</fC03>
<fC03 i1="07" i2="X" l="SPA">
<s0>Recomendación</s0>
<s5>18</s5>
</fC03>
<fC03 i1="08" i2="X" l="FRE">
<s0>Ethique</s0>
<s5>19</s5>
</fC03>
<fC03 i1="08" i2="X" l="ENG">
<s0>Ethics</s0>
<s5>19</s5>
</fC03>
<fC03 i1="08" i2="X" l="SPA">
<s0>Etica</s0>
<s5>19</s5>
</fC03>
<fC03 i1="09" i2="X" l="FRE">
<s0>Nouveau né</s0>
<s5>20</s5>
</fC03>
<fC03 i1="09" i2="X" l="ENG">
<s0>Newborn</s0>
<s5>20</s5>
</fC03>
<fC03 i1="09" i2="X" l="SPA">
<s0>Recién nacido</s0>
<s5>20</s5>
</fC03>
<fC03 i1="10" i2="X" l="FRE">
<s0>Pronostic</s0>
<s5>23</s5>
</fC03>
<fC03 i1="10" i2="X" l="ENG">
<s0>Prognosis</s0>
<s5>23</s5>
</fC03>
<fC03 i1="10" i2="X" l="SPA">
<s0>Pronóstico</s0>
<s5>23</s5>
</fC03>
<fC07 i1="01" i2="X" l="FRE">
<s0>Homme</s0>
</fC07>
<fC07 i1="01" i2="X" l="ENG">
<s0>Human</s0>
</fC07>
<fC07 i1="01" i2="X" l="SPA">
<s0>Hombre</s0>
</fC07>
<fN21>
<s1>144</s1>
</fN21>
</pA>
</standard>
</inist>
</record>

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