Chest compressions in newborn infants: a scoping review

• Published in: Archives of disease in childhood. Fetal and neonatal edition Vol. 108; no. 5; pp. 442 - 450
• Main Authors: Ramachandran, Shalini, Bruckner, Marlies, Wyckoff, Myra H, Schmölzer, Georg M
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health 01.09.2023; BMJ Publishing Group LTD
• Subjects: Cardiology; Cardiopulmonary resuscitation; CPR; Heart rate; Infants; Intensive Care Units, Neonatal; Lifesaving; Neonatal care; Neonatology; Newborn babies; Oxygen; Pediatrics; Resuscitation; Review; Ventilation; Ventilators
• ISSN: 1359-2998; 1468-2052
• DOI: 10.1136/archdischild-2022-324529

AimThe 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.MethodsMEDLINE 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.ResultsSeventy-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.ConclusionThere 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.