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NeoReviews Vol.7 No.9 2006 e454
© 2006 American Academy of Pediatrics

Commentary

More on NRP

The first 20% of the full text of this article appears below.

The 2005 Consensus on Science and Treatment Recommendations of the International Liaison Committee on Resuscitation (ILCOR) serves as the scientific basis for neonatal resuscitation. This consensus reflects the world’s published medical literature and the various perspectives of the representatives to ILCOR from North and South America, Europe, Africa, Australia, and New Zealand. Guidelines reflect not only the science, but also the regional differences in equipment and health priorities. Accordingly, guidelines for the United States may differ in some respects from those of Great Britain or South Africa. The United States guidelines serve as the foundation for the Neonatal Resuscitation Program (NRP) educational program. What are the implications of the new consensus, guidelines, and educational program at the most local level – that of the hospitals and the professionals providing perinatal services? How should the changes be implemented in everyday practice?

The 2005 guidelines incorporate several major changes in approach that mean not only behavioral changes, but also new equipment. New educational tools and areas of emphasis in the NRP offer opportunities and challenges to both instructors and providers of neonatal resuscitation.

Clearly, the most sweeping change in the 2005 guidelines is the possibility of providing positive-pressure ventilation with oxygen concentrations less than 100% during initial resuscitation. This alters the conduct of resuscitation from the immediate rapid assessment performed in the first several seconds after birth. No longer is the question "Is the baby pink?" asked simultaneously with "Is the amniotic fluid clear?", "Is the baby breathing or crying?", "Is there good muscle tone?", and "Is the baby term?". Instead, the first 10 to 15 minutes . . . [Full Text of this Article]

Susan Niermeyer, MD

Editorial Board






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