TY - JOUR
T1 - Neonatal delivery room CPR
T2 - An analysis of the Get with the Guidelines®—Resuscitation Registry
AU - for the American Heart Association’s Get With The Guidelines–Resuscitation Investigators
AU - Halling, Cecilie
AU - Raymond, Tia
AU - Brown, Larry Steven
AU - Ades, Anne
AU - Foglia, Elizabeth E.
AU - Allen, Emilie
AU - Wyckoff, Myra H.
AU - Guerguerian, Anne Marie
AU - Atkins, Dianne
AU - Fink, Ericka
AU - Lasa, Javier J.
AU - Roberts, Joan
AU - Duval-Arnould, Jordan
AU - Bembea, Melania M.
AU - Gaies, Michael
AU - Kleinman, Monica
AU - Gupta, Punkaj
AU - Sutton, Robert M.
AU - Sawyer, Taylor
N1 - Publisher Copyright:
© 2020 Elsevier B.V.
PY - 2021/1
Y1 - 2021/1
N2 - Background: Cardiopulmonary resuscitation (CPR) in the delivery room (DR) after birth is rare. We hypothesized that factors related to maternal, delivery, infant and resuscitation event characteristics associated with outcomes could be identified. We also hypothesized there would be substantial variation from the Neonatal Resuscitation Program (NRP) algorithm. Methods: Retrospective review of all neonates receiving chest compressions in the DR from the AHA Get With The Guidelines—Resuscitation registry from 2001 to 2014. The primary outcome was return of spontaneous circulation (ROSC) in the DR. Secondary outcome was survival to hospital discharge. Descriptive statistics were used to characterize data. Odds ratios with confidence intervals were calculated as appropriate to compare survivors and non-survivors. Results: There were 1153 neonates who received chest compressions in the DR. ROSC was achieved in 968 (84%) newborns and 761 (66%) survived to hospital discharge. Fifty-one percent of the cohort received chest compressions without medications. Cardiac compressions were initiated within the first minute of life in 76% of the events, and prior to endotracheal intubation in 79% of the events. In univariate analysis, factors such as prematurity, number of endotracheal intubation attempts, increased time to first adrenaline dose, and CPR duration were associated with decreased odds of ROSC in the DR. Longer CPR duration was associated with decreased odds of ROSC in multivariate analysis. Conclusion: In this cohort of infants receiving chest compressions following delivery, recognizable pre-birth risk factors as well as resuscitation interventions associated with increased and decreased odds of achieving ROSC were identified. Chest compressions were frequently initiated in the first minute of the event and often prior to endotracheal intubation. Further investigations should focus on methods to decrease time to critical resuscitation interventions, such as successful endotracheal intubation and administration of the first dose of adrenaline, in order to improve DR-CPR outcomes.
AB - Background: Cardiopulmonary resuscitation (CPR) in the delivery room (DR) after birth is rare. We hypothesized that factors related to maternal, delivery, infant and resuscitation event characteristics associated with outcomes could be identified. We also hypothesized there would be substantial variation from the Neonatal Resuscitation Program (NRP) algorithm. Methods: Retrospective review of all neonates receiving chest compressions in the DR from the AHA Get With The Guidelines—Resuscitation registry from 2001 to 2014. The primary outcome was return of spontaneous circulation (ROSC) in the DR. Secondary outcome was survival to hospital discharge. Descriptive statistics were used to characterize data. Odds ratios with confidence intervals were calculated as appropriate to compare survivors and non-survivors. Results: There were 1153 neonates who received chest compressions in the DR. ROSC was achieved in 968 (84%) newborns and 761 (66%) survived to hospital discharge. Fifty-one percent of the cohort received chest compressions without medications. Cardiac compressions were initiated within the first minute of life in 76% of the events, and prior to endotracheal intubation in 79% of the events. In univariate analysis, factors such as prematurity, number of endotracheal intubation attempts, increased time to first adrenaline dose, and CPR duration were associated with decreased odds of ROSC in the DR. Longer CPR duration was associated with decreased odds of ROSC in multivariate analysis. Conclusion: In this cohort of infants receiving chest compressions following delivery, recognizable pre-birth risk factors as well as resuscitation interventions associated with increased and decreased odds of achieving ROSC were identified. Chest compressions were frequently initiated in the first minute of the event and often prior to endotracheal intubation. Further investigations should focus on methods to decrease time to critical resuscitation interventions, such as successful endotracheal intubation and administration of the first dose of adrenaline, in order to improve DR-CPR outcomes.
KW - Adrenaline
KW - Cardiac compressions
KW - Delivery room resuscitation
KW - Neonatal resuscitation
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U2 - 10.1016/j.resuscitation.2020.10.007
DO - 10.1016/j.resuscitation.2020.10.007
M3 - Article
C2 - 33080368
AN - SCOPUS:85095810463
SN - 0300-9572
VL - 158
SP - 236
EP - 242
JO - Resuscitation
JF - Resuscitation
ER -