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2. 2023 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations: Summary From the Basic Life Support; Advanced Life Support; Pediatric Life Support; Neonatal Life Support; Education, Implementation, and Teams; and First Aid Task Forces

Author

Berg, K. M., Bray, J. E., Ng, K. -C., Liley, H. G., Greif, R., Carlson, J. N., Morley, P. T., Drennan, I. R., Smyth, M., Scholefield, B. R., Weiner, G. M., Cheng, A., Djarv, T., Abelairas-Gomez, C., Acworth, J., Andersen, L. W., Atkins, D. L., Berry, D. C., Bhanji, F., Bierens, J., Couto, T. B., Borra, V., Bottiger, B. W., Bradley, R. N., Breckwoldt, J., Cassan, P., Chang, W. -T., Charlton, N. P., Chung, S. P., Considine, J., Costa-Nobre, D. T., Couper, K., Dainty, K. N., Dassanayake, V., Davis, P. G., Dawson, J. A., de Almeida, M. F., De Caen, A. R., Deakin, C. D., Dicker, B., Douma, M. J., Eastwood, K., El-Naggar, W., Fabres, J. G., Fawke, J., Fijacko, N., Finn, J. C., Flores, G. E., Foglia, E. E., Folke, F., Gilfoyle, E., Goolsby, C. A., Granfeldt, A., Guerguerian, A. -M., Guinsburg, R., Hatanaka, T., Hirsch, K. G., Holmberg, M. J., Hosono, S., Hsieh, M. -J., Hsu, C. H., Ikeyama, T., Isayama, T., Johnson, N. J., Kapadia, V. S., Kawakami, M. D., Kim, H. -S., Kleinman, M. E., Kloeck, D. A., Kudenchuk, P., Kule, A., Kurosawa, H., Lagina, A. T., Lauridsen, K. G., Lavonas, E. J., Lee, H. C., Lin, Y., Lockey, A. S., Macneil, F., Maconochie, I. K., Madar, R. J., Hansen, C. M., Masterson, S., Matsuyama, T., Mckinlay, C. J. D., Meyran, D., Monnelly, V., Nadkarni, V., Nakwa, F. L., Nation, K. J., Nehme, Z., Nemeth, M., Neumar, R. W., Nicholson, T., Nikolaou, N., Nishiyama, C., Norii, T., Nuthall, G. A., Ohshimo, S., Olasveengen, T. M., Ong, Y. -K. G., Orkin, A. M., Parr, M. J., Patocka, C., Perkins, G. D., Perlman, J. M., Rabi, Y., Raitt, J., Ramachandran, S., Ramaswamy, V. V., Raymond, T. T., Reis, A. G., Reynolds, J. C., Ristagno, G., Rodriguez-Nunez, A., Roehr, C. C., Rudiger, M., Sakamoto, T., Sandroni, Claudio, Sawyer, T. L., Schexnayder, S. M., Schmolzer, G. M., Schnaubelt, S., Semeraro, F., Singletary, E. M., Skrifvars, M. B., Smith, C. M., Soar, J., Stassen, W., Sugiura, T., Tijssen, J. A., Topjian, A. A., Trevisanuto, D., Vaillancourt, C., Wyckoff, M. H., Wyllie, J. P., Yang, C. -W., Yeung, J., Zelop, C. M., Zideman, D. A., Nolan, J. P., Barcala-Furelos, R., Beerman, S. B., Bruckner, M., Castren, M., Chong, S., Claesson, A., Dunne, C. L., Finan, E., Fukuda, T., Ganesan, S. L., Gately, C., Gois, A., Gray, S., Halamek, L. P., Hoover, A. V., Hurst, C., Josephsen, J., Kollander, L., Kamlin, C. O., Kool, M., Li, L., Mecrow, T. S., Montgomery, W., Ristau, P., Jayashree, M., Schmidt, A., Scquizzato, T. -M., Seesink, J., Sempsrott, J., Solevag, A. L., Strand, M. L., Szpilman, D., Szyld, E., Thom, O., Tobin, J. M., Trang, J., Webber, J., Webster, H. K., Wellsford, M., Sandroni C. (ORCID:0000-0002-8878-2611), Berg, K. M., Bray, J. E., Ng, K. -C., Liley, H. G., Greif, R., Carlson, J. N., Morley, P. T., Drennan, I. R., Smyth, M., Scholefield, B. R., Weiner, G. M., Cheng, A., Djarv, T., Abelairas-Gomez, C., Acworth, J., Andersen, L. W., Atkins, D. L., Berry, D. C., Bhanji, F., Bierens, J., Couto, T. B., Borra, V., Bottiger, B. W., Bradley, R. N., Breckwoldt, J., Cassan, P., Chang, W. -T., Charlton, N. P., Chung, S. P., Considine, J., Costa-Nobre, D. T., Couper, K., Dainty, K. N., Dassanayake, V., Davis, P. G., Dawson, J. A., de Almeida, M. F., De Caen, A. R., Deakin, C. D., Dicker, B., Douma, M. J., Eastwood, K., El-Naggar, W., Fabres, J. G., Fawke, J., Fijacko, N., Finn, J. C., Flores, G. E., Foglia, E. E., Folke, F., Gilfoyle, E., Goolsby, C. A., Granfeldt, A., Guerguerian, A. -M., Guinsburg, R., Hatanaka, T., Hirsch, K. G., Holmberg, M. J., Hosono, S., Hsieh, M. -J., Hsu, C. H., Ikeyama, T., Isayama, T., Johnson, N. J., Kapadia, V. S., Kawakami, M. D., Kim, H. -S., Kleinman, M. E., Kloeck, D. A., Kudenchuk, P., Kule, A., Kurosawa, H., Lagina, A. T., Lauridsen, K. G., Lavonas, E. J., Lee, H. C., Lin, Y., Lockey, A. S., Macneil, F., Maconochie, I. K., Madar, R. J., Hansen, C. M., Masterson, S., Matsuyama, T., Mckinlay, C. J. D., Meyran, D., Monnelly, V., Nadkarni, V., Nakwa, F. L., Nation, K. J., Nehme, Z., Nemeth, M., Neumar, R. W., Nicholson, T., Nikolaou, N., Nishiyama, C., Norii, T., Nuthall, G. A., Ohshimo, S., Olasveengen, T. M., Ong, Y. -K. G., Orkin, A. M., Parr, M. J., Patocka, C., Perkins, G. D., Perlman, J. M., Rabi, Y., Raitt, J., Ramachandran, S., Ramaswamy, V. V., Raymond, T. T., Reis, A. G., Reynolds, J. C., Ristagno, G., Rodriguez-Nunez, A., Roehr, C. C., Rudiger, M., Sakamoto, T., Sandroni, Claudio, Sawyer, T. L., Schexnayder, S. M., Schmolzer, G. M., Schnaubelt, S., Semeraro, F., Singletary, E. M., Skrifvars, M. B., Smith, C. M., Soar, J., Stassen, W., Sugiura, T., Tijssen, J. A., Topjian, A. A., Trevisanuto, D., Vaillancourt, C., Wyckoff, M. H., Wyllie, J. P., Yang, C. -W., Yeung, J., Zelop, C. M., Zideman, D. A., Nolan, J. P., Barcala-Furelos, R., Beerman, S. B., Bruckner, M., Castren, M., Chong, S., Claesson, A., Dunne, C. L., Finan, E., Fukuda, T., Ganesan, S. L., Gately, C., Gois, A., Gray, S., Halamek, L. P., Hoover, A. V., Hurst, C., Josephsen, J., Kollander, L., Kamlin, C. O., Kool, M., Li, L., Mecrow, T. S., Montgomery, W., Ristau, P., Jayashree, M., Schmidt, A., Scquizzato, T. -M., Seesink, J., Sempsrott, J., Solevag, A. L., Strand, M. L., Szpilman, D., Szyld, E., Thom, O., Tobin, J. M., Trang, J., Webber, J., Webster, H. K., Wellsford, M., and Sandroni C. (ORCID:0000-0002-8878-2611)

Abstract

The International Liaison Committee on Resuscitation engages in a continuous review of new, peer-reviewed, published cardiopulmonary resuscitation and first aid science. Draft Consensus on Science With Treatment Recommendations are posted online throughout the year, and this annual summary provides more concise versions of the final Consensus on Science With Treatment Recommendations from all task forces for the year. Topics addressed by systematic reviews this year include resuscitation of cardiac arrest from drowning, extracorporeal cardiopulmonary resuscitation for adults and children, calcium during cardiac arrest, double sequential defibrillation, neuroprognostication after cardiac arrest for adults and children, maintaining normal temperature after preterm birth, heart rate monitoring methods for diagnostics in neonates, detection of exhaled carbon dioxide in neonates, family presence during resuscitation of adults, and a stepwise approach to resuscitation skills training. Members from 6 International Liaison Committee on Resuscitation task forces have assessed, discussed, and debated the quality of the evidence, using Grading of Recommendations Assessment, Development, and Evaluation criteria, and their statements include consensus treatment recommendations. Insights into the deliberations of the task forces are provided in the Justification and Evidence-to-Decision Framework Highlights sections. In addition, the task forces list priority knowledge gaps for further research. Additional topics are addressed with scoping reviews and evidence updates.

Published
2023

4. NETwork Meta-analysis Of Trials of Initial Oxygen in preterm Newborns (NETMOTION): A Protocol for Systematic Review and Individual Participant Data Network Meta-Analysis of Preterm Infants <32 Weeks' Gestation Randomized to Initial Oxygen Concentration for Resuscitation

Author

Sotiropoulos, J.X., Oei, J.L., Schmolzer, G.M., Hunter, K.E., Williams, J.G., Webster, A.C., Vento, M., Kapadia, V., Rabi, Y., Dekker, J., Vermeulen, M.J., Sundaram, V., Kumar, P., Saugstad, O.D., and Seidler, A.L.

Subjects
Individual participant data meta-analysis, Preterm birth, Oxygen concentration, Neonatal resuscitation, Network meta-analysis
Abstract

Background: Internationally recognized guidelines recommend the judicious use of low oxygen (21-30%), titrated to peripheral oxygen saturation targets, for the initiation of re- suscitation of very and extremely preterm infants (= 90%) oxygen. A two-step random-effects contrastbased network meta-regression will be calculated to compare and rank different oxygen concentrations. Analyses will be intention-to-treat, with the primary outcome of all-cause mortality. Discussion: This is the first individual participant data network meta-analysis of initial oxygen concentrations for the resuscitation of preterm infants. This novel approach may address long-standing uncertainty regarding optimal oxygen supplementation practice for the resuscitation of preterm infants

Published
2022

5. 2022 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science with Treatment Recommendations: Summary from the Basic Life Support; Advanced Life Support; Pediatric Life Support; Neonatal Life Support; Education, Implementation, and Teams; And First Aid Task Forces

Author

Wyckoff, M. H., Greif, R., Morley, P. T., Ng, K. -C., Olasveengen, T. M., Singletary, E. M., Soar, J., Cheng, A., Drennan, I. R., Liley, H. G., Scholefield, B. R., Smyth, M. A., Welsford, M., Zideman, D. A., Acworth, J., Aickin, R., Andersen, L. W., Atkins, D., Berry, D. C., Bhanji, F., Bierens, J., Borra, V., Bottiger, B. W., Bradley, R. N., Bray, J. E., Breckwoldt, J., Callaway, C. W., Carlson, J. N., Cassan, P., Castren, M., Chang, W. -T., Charlton, N. P., Chung, S. P., Considine, J., Costa-Nobre, D. T., Couper, K., Couto, T. B., Dainty, K. N., Davis, P. G., De Almeida, M. F., De Caen, A. R., Deakin, C. D., Djarv, T., Donnino, M. W., Douma, M. J., Duff, J. P., Dunne, C. L., Eastwood, K., El-Naggar, W., Fabres, J. G., Fawke, J., Finn, J., Foglia, E. E., Folke, F., Gilfoyle, E., Goolsby, C. A., Granfeldt, A., Guerguerian, A. -M., Guinsburg, R., Hirsch, K. G., Holmberg, M. J., Hosono, S., Hsieh, M. -J., Hsu, C. H., Ikeyama, T., Isayama, T., Johnson, N. J., Kapadia, V. S., Kawakami, M. D., Kim, H. -S., Kleinman, M., Kloeck, D. A., Kudenchuk, P. J., Lagina, A. T., Lauridsen, K. G., Lavonas, E. J., Lee, H. C., Lin, Y. (., Lockey, A. S., Maconochie, I. K., Madar, R. J., Malta Hansen, C., Masterson, S., Matsuyama, T., Mckinlay, C. J. D., Meyran, D., Morgan, P., Morrison, L. J., Nadkarni, V., Nakwa, F. L., Nation, K. J., Nehme, Z., Nemeth, M., Neumar, R. W., Nicholson, T., Nikolaou, N., Nishiyama, C., Norii, T., Nuthall, G. A., O'Neill, B. J., Ong, Y. -K. G., Orkin, A. M., Paiva, E. F., Parr, M. J., Patocka, C., Pellegrino, J. L., Perkins, G. D., Perlman, J. M., Rabi, Y., Reis, A. G., Reynolds, J. C., Ristagno, G., Rodriguez-Nunez, A., Roehr, C. C., Rudiger, M., Sakamoto, T., Sandroni, Claudio, Sawyer, T. L., Schexnayder, S. M., Schmolzer, G. M., Schnaubelt, S., Semeraro, F., Skrifvars, M. B., Smith, C. M., Sugiura, T., Tijssen, J. A., Trevisanuto, D., Van De Voorde, P., Wang, T. -L., Weiner, G. M., Wyllie, J. P., Yang, C. -W., Yeung, J., Nolan, J. P., Berg, K. M., Burdick, M. C., Cartledge, S., Dawson, J. A., Elgohary, M. M., Ersdal, H. L., Finan, E., Flaatten, H. I., Flores, G. E., Fuerch, J., Garg, R., Gately, C., Goh, M., Halamek, L. P., Handley, A. J., Hatanaka, T., Hoover, A., Issa, M., Johnson, S., Kamlin, C. O., Ko, Y. -C., Kule, A., Leone, T. A., Mackenzie, E., Macneil, F., Montgomery, W., O'Dochartaigh, D., Ohshimo, S., Palazzo, F. S., Picard, C., Quek, B. H., Raitt, J., Ramaswamy, V. V., Scapigliati, Andrea, Shah, B. A., Stewart, C., Strand, M. L., Szyld, E., Thio, M., Topjian, A. A., Udaeta, E., Vaillancourt, C., Wetsch, W. A., Wigginton, J., Yamada, N. K., Yao, S., Zace, D., Zelop, C. M., Sandroni C. (ORCID:0000-0002-8878-2611), Scapigliati A. (ORCID:0000-0002-4044-2343), Wyckoff, M. H., Greif, R., Morley, P. T., Ng, K. -C., Olasveengen, T. M., Singletary, E. M., Soar, J., Cheng, A., Drennan, I. R., Liley, H. G., Scholefield, B. R., Smyth, M. A., Welsford, M., Zideman, D. A., Acworth, J., Aickin, R., Andersen, L. W., Atkins, D., Berry, D. C., Bhanji, F., Bierens, J., Borra, V., Bottiger, B. W., Bradley, R. N., Bray, J. E., Breckwoldt, J., Callaway, C. W., Carlson, J. N., Cassan, P., Castren, M., Chang, W. -T., Charlton, N. P., Chung, S. P., Considine, J., Costa-Nobre, D. T., Couper, K., Couto, T. B., Dainty, K. N., Davis, P. G., De Almeida, M. F., De Caen, A. R., Deakin, C. D., Djarv, T., Donnino, M. W., Douma, M. J., Duff, J. P., Dunne, C. L., Eastwood, K., El-Naggar, W., Fabres, J. G., Fawke, J., Finn, J., Foglia, E. E., Folke, F., Gilfoyle, E., Goolsby, C. A., Granfeldt, A., Guerguerian, A. -M., Guinsburg, R., Hirsch, K. G., Holmberg, M. J., Hosono, S., Hsieh, M. -J., Hsu, C. H., Ikeyama, T., Isayama, T., Johnson, N. J., Kapadia, V. S., Kawakami, M. D., Kim, H. -S., Kleinman, M., Kloeck, D. A., Kudenchuk, P. J., Lagina, A. T., Lauridsen, K. G., Lavonas, E. J., Lee, H. C., Lin, Y. (., Lockey, A. S., Maconochie, I. K., Madar, R. J., Malta Hansen, C., Masterson, S., Matsuyama, T., Mckinlay, C. J. D., Meyran, D., Morgan, P., Morrison, L. J., Nadkarni, V., Nakwa, F. L., Nation, K. J., Nehme, Z., Nemeth, M., Neumar, R. W., Nicholson, T., Nikolaou, N., Nishiyama, C., Norii, T., Nuthall, G. A., O'Neill, B. J., Ong, Y. -K. G., Orkin, A. M., Paiva, E. F., Parr, M. J., Patocka, C., Pellegrino, J. L., Perkins, G. D., Perlman, J. M., Rabi, Y., Reis, A. G., Reynolds, J. C., Ristagno, G., Rodriguez-Nunez, A., Roehr, C. C., Rudiger, M., Sakamoto, T., Sandroni, Claudio, Sawyer, T. L., Schexnayder, S. M., Schmolzer, G. M., Schnaubelt, S., Semeraro, F., Skrifvars, M. B., Smith, C. M., Sugiura, T., Tijssen, J. A., Trevisanuto, D., Van De Voorde, P., Wang, T. -L., Weiner, G. M., Wyllie, J. P., Yang, C. -W., Yeung, J., Nolan, J. P., Berg, K. M., Burdick, M. C., Cartledge, S., Dawson, J. A., Elgohary, M. M., Ersdal, H. L., Finan, E., Flaatten, H. I., Flores, G. E., Fuerch, J., Garg, R., Gately, C., Goh, M., Halamek, L. P., Handley, A. J., Hatanaka, T., Hoover, A., Issa, M., Johnson, S., Kamlin, C. O., Ko, Y. -C., Kule, A., Leone, T. A., Mackenzie, E., Macneil, F., Montgomery, W., O'Dochartaigh, D., Ohshimo, S., Palazzo, F. S., Picard, C., Quek, B. H., Raitt, J., Ramaswamy, V. V., Scapigliati, Andrea, Shah, B. A., Stewart, C., Strand, M. L., Szyld, E., Thio, M., Topjian, A. A., Udaeta, E., Vaillancourt, C., Wetsch, W. A., Wigginton, J., Yamada, N. K., Yao, S., Zace, D., Zelop, C. M., Sandroni C. (ORCID:0000-0002-8878-2611), and Scapigliati A. (ORCID:0000-0002-4044-2343)

Abstract

This is the sixth annual summary of the International Liaison Committee on Resuscitation International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations. This summary addresses the most recently published resuscitation evidence reviewed by International Liaison Committee on Resuscitation Task Force science experts. Topics covered by systematic reviews include cardiopulmonary resuscitation during transport; approach to resuscitation after drowning; passive ventilation; minimizing pauses during cardiopulmonary resuscitation; temperature management after cardiac arrest; use of diagnostic point-of-care ultrasound during cardiac arrest; use of vasopressin and corticosteroids during cardiac arrest; coronary angiography after cardiac arrest; public-access defibrillation devices for children; pediatric early warning systems; maintaining normal temperature immediately after birth; suctioning of amniotic fluid at birth; tactile stimulation for resuscitation immediately after birth; use of continuous positive airway pressure for respiratory distress at term birth; respiratory and heart rate monitoring in the delivery room; supraglottic airway use in neonates; prearrest prediction of in-hospital cardiac arrest mortality; basic life support training for likely rescuers of high-risk populations; effect of resuscitation team training; blended learning for life support training; training and recertification for resuscitation instructors; and recovery position for maintenance of breathing and prevention of cardiac arrest. Members from 6 task forces have assessed, discussed, and debated the quality of the evidence using Grading of Recommendations Assessment, Development, and Evaluation criteria and generated consensus treatment recommendations. Insights into the deliberations of the task forces are provided in the Justification and Evidence-to-Decision Framework Highlights sections, and priority knowledge gaps for futu

Published
2022

6. 2021 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations: Summary From the Basic Life Support; Advanced Life Support; Neonatal Life Support; Education, Implementation, and Teams; First Aid Task Forces; and the COVID-19 Working Group

Author

Wyckoff, Mh, Singletary, Em, Soar, J, Olasveengen, Tm, Greif, R, Liley, Hg, Zideman, D, Bhanji, F, Andersen, Lw, Avis, Sr, Aziz, K, Bendall, Jc, Berry, Dc, Borra, V, Bottiger, Bw, Bradley, R, Bray, Je, Breckwoldt, J, Carlson, Jn, Cassan, P, Castren, M, Chang, Wt, Charlton, Np, Cheng, A, Chung, Sp, Considine, J, Costa-Nobre, Dt, Couper, K, Dainty, Kn, Davis, Pg, de Almeida, Mf, de Caen, Ar, de Paiva, Ef, Deakin, Cd, Djarv, T, Douma, Mj, Drennan, Ir, Duff, Jp, Eastwood, Kj, El-Naggar, W, Epstein, Jl, Escalante, R, Fabres, Jg, Fawke, J, Finn, Jc, Foglia, Ee, Folke, F, Freeman, K, Gilfoyle, E, Goolsby, Ca, Grove, A, Guinsburg, R, Hatanaka, T, Hazinski, Mf, Heriot, G, Hirsch, Kg, Holmberg, Mj, Hosono, S, Hsieh, Mj, Hung, Kkc, Hsu, Ch, Ikeyama, T, Isayama, T, Kapadia, V, Kawakami, Md, Kim, H, Kloeck, Da, Kudenchuk, Pj, Lagina, At, Lauridsen, Kg, Lavonas, Ej, Lockey, A, Hansen, Cm, Markenson, D, Matsuyama, T, McKinlay, Cjd, Mehrabian, A, Merchant, Rm, Meyran, D, Morley, Pt, Morrison, Lj, Nation, Kj, Nemeth, M, Neumar, Rw, Nicholson, T, Niermeyer, S, Nikolaou, N, Nishiyama, C, O'Neil, Bj, Orkin, Am, Osemeke, O, Parr, Mj, Patocka, C, Pellegrino, Jl, Perkins, Gd, Perlman, Jm, Rabi, Y, Reynolds, Jc, Ristagno, G, Roehr, Cc, Sakamoto, T, Sandroni, C, Sawyer, T, Schmolzer, Gm, Schnaubelt, S, Semeraro, F, Skrifvars, Mb, Smith, Cm, Smyth, Ma, Soll, Rf, Sugiura, T, Taylor-Phillips, S, Trevisanuto, D, Vaillancourt, C, Wang, Tl, Weiner, Gm, Welsford, M, Wigginton, J, Wyllie, Jp, Yeung, J, Nolan, Jp, Berg, Km, Sandroni, C (ORCID:0000-0002-8878-2611), Wyckoff, Mh, Singletary, Em, Soar, J, Olasveengen, Tm, Greif, R, Liley, Hg, Zideman, D, Bhanji, F, Andersen, Lw, Avis, Sr, Aziz, K, Bendall, Jc, Berry, Dc, Borra, V, Bottiger, Bw, Bradley, R, Bray, Je, Breckwoldt, J, Carlson, Jn, Cassan, P, Castren, M, Chang, Wt, Charlton, Np, Cheng, A, Chung, Sp, Considine, J, Costa-Nobre, Dt, Couper, K, Dainty, Kn, Davis, Pg, de Almeida, Mf, de Caen, Ar, de Paiva, Ef, Deakin, Cd, Djarv, T, Douma, Mj, Drennan, Ir, Duff, Jp, Eastwood, Kj, El-Naggar, W, Epstein, Jl, Escalante, R, Fabres, Jg, Fawke, J, Finn, Jc, Foglia, Ee, Folke, F, Freeman, K, Gilfoyle, E, Goolsby, Ca, Grove, A, Guinsburg, R, Hatanaka, T, Hazinski, Mf, Heriot, G, Hirsch, Kg, Holmberg, Mj, Hosono, S, Hsieh, Mj, Hung, Kkc, Hsu, Ch, Ikeyama, T, Isayama, T, Kapadia, V, Kawakami, Md, Kim, H, Kloeck, Da, Kudenchuk, Pj, Lagina, At, Lauridsen, Kg, Lavonas, Ej, Lockey, A, Hansen, Cm, Markenson, D, Matsuyama, T, McKinlay, Cjd, Mehrabian, A, Merchant, Rm, Meyran, D, Morley, Pt, Morrison, Lj, Nation, Kj, Nemeth, M, Neumar, Rw, Nicholson, T, Niermeyer, S, Nikolaou, N, Nishiyama, C, O'Neil, Bj, Orkin, Am, Osemeke, O, Parr, Mj, Patocka, C, Pellegrino, Jl, Perkins, Gd, Perlman, Jm, Rabi, Y, Reynolds, Jc, Ristagno, G, Roehr, Cc, Sakamoto, T, Sandroni, C, Sawyer, T, Schmolzer, Gm, Schnaubelt, S, Semeraro, F, Skrifvars, Mb, Smith, Cm, Smyth, Ma, Soll, Rf, Sugiura, T, Taylor-Phillips, S, Trevisanuto, D, Vaillancourt, C, Wang, Tl, Weiner, Gm, Welsford, M, Wigginton, J, Wyllie, Jp, Yeung, J, Nolan, Jp, Berg, Km, and Sandroni, C (ORCID:0000-0002-8878-2611)

Abstract

The International Liaison Committee on Resuscitation initiated a continuous review of new, peer-reviewed published cardiopulmonary resuscitation science. This is the fifth annual summary of the International Liaison Committee on Resuscitation International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations; a more comprehensive review was done in 2020. This latest summary addresses the most recently published resuscitation evidence reviewed by International Liaison Committee on Resuscitation task force science experts. Topics covered by systematic reviews in this summary include resuscitation topics of video-based dispatch systems; head-up cardiopulmonary resuscitation; early coronary angiography after return of spontaneous circulation; cardiopulmonary resuscitation in the prone patient; cord management at birth for preterm and term infants; devices for administering positive-pressure ventilation at birth; family presence during neonatal resuscitation; self-directed, digitally based basic life support education and training in adults and children; coronavirus disease 2019 infection risk to rescuers from patients in cardiac arrest; and first aid topics, including cooling with water for thermal burns, oral rehydration for exertional dehydration, pediatric tourniquet use, and methods of tick removal. Members from 6 International Liaison Committee on Resuscitation task forces have assessed, discussed, and debated the quality of the evidence, according to the Grading of Recommendations Assessment, Development, and Evaluation criteria, and their statements include consensus treatment recommendations or good practice statements. Insights into the deliberations of the task forces are provided in Justification and Evidence-to-Decision Framework Highlights sections. In addition, the task forces listed priority knowledge gaps for further research.

Published
2022

8. Outcomes of delivery room resuscitation of bradycardic preterm infants: A retrospective cohort study of randomised trials of high vs low initial oxygen concentration and an individual patient data analysis

Author

Kapadia V, Oei JL, Finer N, Rich W, Rabi Y, Wright IM, Rook D, Vermeulen MJ, Tarnow-Mordi WO, Smyth JP, Lui K, Brown S, Saugstad OD, and Vento M

Subjects
Death, Oxygen, Neonatal Resuscitation Program, Intraventricular hemorrhage, Oxygen saturation, Heart rate, Bradycardia, Systematic review, Neonatal resuscitation, Mortality, Newborn, Bronchopulmonary dysplasia, International Liaison Committee on Resuscitation
Abstract

Objective: To determine whether hospital mortality (primary outcome) is associated with duration of bradycardia without chest compressions during delivery room (DR) resuscitation in a retrospective cohort study of randomized controlled trials (RCTs) in preterm infants assigned low versus high initial oxygen concentration. Methods: Medline and EMBASE were searched from 01/01/1990 to 12/01/2020. RCTs of low vs high initial oxygen concentration which recorded serial heart rate (HR) and oxygen saturation (SpO(2)) during resuscitation of infants = 2 min. Individual patient data analysis and pooled data analysis were conducted. Results: Data were collected from 720 infants in 8 RCTs. Neonates with PB had higher odds of hospital death before [OR 3.8 (95% CI 1.5, 9.3)] and after [OR 1.7 (1.2, 2.5)] adjusting for potential confounders. Bradycardia occurred in 58% infants, while 38% had PB. Infants with bradycardia were more premature and had lower birth weights. The incidence of bradycardia in infants resuscitated with low (= 60%) oxygen was similar. Neonates with both, PB and SpO(2) < 80% at 5 min after birth had higher odds of hospital mortality. [OR 18.6 (4.3, 79.7)]. Conclusion: In preterm infants who did not receive chest compressions in the DR, prolonged bradycardia is associated with hospital mortality.

Published
2021

9. Neurodevelopmental outcomes of preterm infants after randomisation to initial resuscitation with lower (FiO 2 < 0.3) or higher (FiO 2 > 0.6) initial oxygen levels. An individual patient meta-analysis

Author

Oei JL, Kapadia V, Rabi Y, Saugstad OD, Rook D, Vermeulen MJ, Boronat N, Thamrin V, Tarnow-Mordi W, Smyth J, Wright IM, Lui K, van Goudoever JB, Gebski V, and Vento M

Subjects
neonatology, resuscitation
Abstract

To determine the effects of lower (=0.3) versus higher (=0.6) initial fractional inspired oxygen (FiO 2 ) for resuscitation on death and/or neurodevelopmental impairment (NDI) in infants

Published
2021

10. 2021 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations: Summary From the Basic Life Support; Advanced Life Support; Neonatal Life Support; Education, Implementation, and Teams; First Aid Task Forces; and the COVID-19 Working Group

Author

Wyckoff, M. H., Singletary, E. M., Soar, J., Olasveengen, T. M., Greif, R., Liley, H. G., Zideman, D., Bhanji, F., Andersen, L. W., Avis, S. R., Aziz, K., Bendall, J. C., Berry, D. C., Borra, V., Bottiger, B. W., Bradley, R., Bray, J. E., Breckwoldt, J., Carlson, J. N., Cassan, P., Castren, M., Chang, W. -T., Charlton, N. P., Cheng, A., Chung, S. P., Considine, J., Costa-Nobre, D. T., Couper, K., Dainty, K. N., Davis, P. G., de Almeida, M. F., de Caen, A. R., de Paiva, E. F., Deakin, C. D., Djarv, T., Douma, M. J., Drennan, I. R., Duff, J. P., Eastwood, K. J., El-Naggar, W., Epstein, J. L., Escalante, R., Fabres, J. G., Fawke, J., Finn, J. C., Foglia, E. E., Folke, F., Freeman, K., Gilfoyle, E., Goolsby, C. A., Grove, A., Guinsburg, R., Hatanaka, T., Hazinski, M. F., Heriot, G. S., Hirsch, K. G., Holmberg, M. J., Hosono, S., Hsieh, M. -J., Hung, K. K. C., Hsu, C. H., Ikeyama, T., Isayama, T., Kapadia, V. S., Kawakami, M. D., Kim, H. -S., Kloeck, D. A., Kudenchuk, P. J., Lagina, A. T., Lauridsen, K. G., Lavonas, E. J., Lockey, A. S., Malta Hansen, C., Markenson, D., Matsuyama, T., Mckinlay, C. J. D., Mehrabian, A., Merchant, R. M., Meyran, D., Morley, P. T., Morrison, L. J., Nation, K. J., Nemeth, M., Neumar, R. W., Nicholson, T., Niermeyer, S., Nikolaou, N., Nishiyama, C., O'Neil, B. J., Orkin, A. M., Osemeke, O., Parr, M. J., Patocka, C., Pellegrino, J. L., Perkins, G. D., Perlman, J. M., Rabi, Y., Reynolds, J. C., Ristagno, G., Roehr, C. C., Sakamoto, T., Sandroni, Claudio, Sawyer, T., Schmolzer, G. M., Schnaubelt, S., Semeraro, F., Skrifvars, M. B., Smith, C. M., Smyth, M. A., Soll, R. F., Sugiura, T., Taylor-Phillips, S., Trevisanuto, D., Vaillancourt, C., Wang, T. -L., Weiner, G. M., Welsford, M., Wigginton, J., Wyllie, J. P., Yeung, J., Nolan, J. P., Berg, K. M., Abelairas-Gomez, C., Barcala-Furelos, R., Beerman, S. B., Bierens, J., Cacciola, Sofia, Cellini, J., Claesson, A., Court, R., D'Arrigo, Sonia, De Brier, N., Dunne, C. L., Elsenga, H. E., Johnson, S., Kleven, G., Maconochie, I., Mecrow, T., Morgan, P., Otto, Q., Palmieri, T. L., Parnia, S., Pawar, R., Pereira, J., Rudd, S., Scapigliati, Andrea, Schmidt, A., Seesink, J., Sempsrott, J. R., Szpilman, D., Warner, D. S., Webber, J. B., West, R. L., Sandroni C. (ORCID:0000-0002-8878-2611), Cacciola S., D'Arrigo S. (ORCID:0000-0001-6740-3195), Scapigliati A. (ORCID:0000-0002-4044-2343), Wyckoff, M. H., Singletary, E. M., Soar, J., Olasveengen, T. M., Greif, R., Liley, H. G., Zideman, D., Bhanji, F., Andersen, L. W., Avis, S. R., Aziz, K., Bendall, J. C., Berry, D. C., Borra, V., Bottiger, B. W., Bradley, R., Bray, J. E., Breckwoldt, J., Carlson, J. N., Cassan, P., Castren, M., Chang, W. -T., Charlton, N. P., Cheng, A., Chung, S. P., Considine, J., Costa-Nobre, D. T., Couper, K., Dainty, K. N., Davis, P. G., de Almeida, M. F., de Caen, A. R., de Paiva, E. F., Deakin, C. D., Djarv, T., Douma, M. J., Drennan, I. R., Duff, J. P., Eastwood, K. J., El-Naggar, W., Epstein, J. L., Escalante, R., Fabres, J. G., Fawke, J., Finn, J. C., Foglia, E. E., Folke, F., Freeman, K., Gilfoyle, E., Goolsby, C. A., Grove, A., Guinsburg, R., Hatanaka, T., Hazinski, M. F., Heriot, G. S., Hirsch, K. G., Holmberg, M. J., Hosono, S., Hsieh, M. -J., Hung, K. K. C., Hsu, C. H., Ikeyama, T., Isayama, T., Kapadia, V. S., Kawakami, M. D., Kim, H. -S., Kloeck, D. A., Kudenchuk, P. J., Lagina, A. T., Lauridsen, K. G., Lavonas, E. J., Lockey, A. S., Malta Hansen, C., Markenson, D., Matsuyama, T., Mckinlay, C. J. D., Mehrabian, A., Merchant, R. M., Meyran, D., Morley, P. T., Morrison, L. J., Nation, K. J., Nemeth, M., Neumar, R. W., Nicholson, T., Niermeyer, S., Nikolaou, N., Nishiyama, C., O'Neil, B. J., Orkin, A. M., Osemeke, O., Parr, M. J., Patocka, C., Pellegrino, J. L., Perkins, G. D., Perlman, J. M., Rabi, Y., Reynolds, J. C., Ristagno, G., Roehr, C. C., Sakamoto, T., Sandroni, Claudio, Sawyer, T., Schmolzer, G. M., Schnaubelt, S., Semeraro, F., Skrifvars, M. B., Smith, C. M., Smyth, M. A., Soll, R. F., Sugiura, T., Taylor-Phillips, S., Trevisanuto, D., Vaillancourt, C., Wang, T. -L., Weiner, G. M., Welsford, M., Wigginton, J., Wyllie, J. P., Yeung, J., Nolan, J. P., Berg, K. M., Abelairas-Gomez, C., Barcala-Furelos, R., Beerman, S. B., Bierens, J., Cacciola, Sofia, Cellini, J., Claesson, A., Court, R., D'Arrigo, Sonia, De Brier, N., Dunne, C. L., Elsenga, H. E., Johnson, S., Kleven, G., Maconochie, I., Mecrow, T., Morgan, P., Otto, Q., Palmieri, T. L., Parnia, S., Pawar, R., Pereira, J., Rudd, S., Scapigliati, Andrea, Schmidt, A., Seesink, J., Sempsrott, J. R., Szpilman, D., Warner, D. S., Webber, J. B., West, R. L., Sandroni C. (ORCID:0000-0002-8878-2611), Cacciola S., D'Arrigo S. (ORCID:0000-0001-6740-3195), and Scapigliati A. (ORCID:0000-0002-4044-2343)

Abstract

The International Liaison Committee on Resuscitation initiated a continuous review of new, peer-reviewed published cardiopulmonary resuscitation science. This is the fifth annual summary of the International Liaison Committee on Resuscitation International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations; a more comprehensive review was done in 2020. This latest summary addresses the most recently published resuscitation evidence reviewed by International Liaison Committee on Resuscitation task force science experts. Topics covered by systematic reviews in this summary include resuscitation topics of video-based dispatch systems; head-up cardiopulmonary resuscitation; early coronary angiography after return of spontaneous circulation; cardiopulmonary resuscitation in the prone patient; cord management at birth for preterm and term infants; devices for administering positive-pressure ventilation at birth; family presence during neonatal resuscitation; self-directed, digitally based basic life support education and training in adults and children; coronavirus disease 2019 infection risk to rescuers from patients in cardiac arrest; and first aid topics, including cooling with water for thermal burns, oral rehydration for exertional dehydration, pediatric tourniquet use, and methods of tick removal. Members from 6 International Liaison Committee on Resuscitation task forces have assessed, discussed, and debated the quality of the evidence, according to the Grading of Recommendations Assessment, Development, and Evaluation criteria, and their statements include consensus treatment recommendations or good practice statements. Insights into the deliberations of the task forces are provided in Justification and Evidence-to-Decision Framework Highlights sections. In addition, the task forces listed priority knowledge gaps for further research.

Published
2021

12. 2019 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science with Treatment Recommendations: Summary from the Basic Life Support; Advanced Life Support; Pediatric Life Support; Neonatal Life Support; Education, Implementation, and Teams; And First Aid Task Forces

Author

Soar, J., Maconochie, I., Wyckoff, M. H., Olasveengen, T. M., Singletary, E. M., Greif, R., Aickin, R., Bhanji, F., Donnino, M. W., Mancini, M. E., Wyllie, J. P., Zideman, D., Andersen, L. W., Atkins, D. L., Aziz, K., Bendall, J., Berg, K. M., Berry, D. C., Bigham, B. L., Bingham, R., Couto, T. B., Bottiger, B. W., Borra, V., Bray, J. E., Breckwoldt, J., Brooks, S. C., Buick, J., Callaway, C. W., Carlson, J. N., Cassan, P., Castren, M., Chang, W. -T., Charlton, N. P., Cheng, A., Chung, S. P., Considine, J., Couper, K., Dainty, K. N., Dawson, J. A., De Almeida, M. F., De Caen, A. R., Deakin, C. D., Drennan, I. R., Duff, J. P., Epstein, J. L., Escalante, R., Gazmuri, R. J., Gilfoyle, E., Granfeldt, A., Guerguerian, A. -M., Guinsburg, R., Hatanaka, T., Holmberg, M. J., Hood, N., Hosono, S., Hsieh, M. -J., Isayama, T., Iwami, T., Jensen, J. L., Kapadia, V., Kim, H. -S., Kleinman, M. E., Kudenchuk, P. J., Lang, E., Lavonas, E., Liley, H., Lim, S. H., Lockey, A., Lofgren, B., Ma, M. H. -M., Markenson, D., Meaney, P. A., Meyran, D., Mildenhall, L., Monsieurs, K. G., Montgomery, W., Morley, P. T., Morrison, L. J., Nadkarni, V. M., Nation, K., Neumar, R. W., Ng, K. -C., Nicholson, T., Nikolaou, N., Nishiyama, C., Nuthall, G., Ohshimo, S., Okamoto, D., O'Neil, B., Yong-Kwang Ong, G., Paiva, E. F., Parr, M., Pellegrino, J. L., Perkins, G. D., Perlman, J., Rabi, Y., Reis, A., Reynolds, J. C., Ristagno, G., Roehr, C. C., Sakamoto, T., Sandroni, Claudio, Schexnayder, S. M., Scholefield, B. R., Shimizu, N., Skrifvars, M. B., Smyth, M. A., Stanton, D., Swain, J., Szyld, E., Tijssen, J., Travers, A., Trevisanuto, D., Vaillancourt, C., Van De Voorde, P., Velaphi, S., Wang, T. -L., Weiner, G., Welsford, M., Woodin, J. A., Yeung, J., Nolan, J. P., Fran Hazinski, M., Sandroni C. (ORCID:0000-0002-8878-2611), Soar, J., Maconochie, I., Wyckoff, M. H., Olasveengen, T. M., Singletary, E. M., Greif, R., Aickin, R., Bhanji, F., Donnino, M. W., Mancini, M. E., Wyllie, J. P., Zideman, D., Andersen, L. W., Atkins, D. L., Aziz, K., Bendall, J., Berg, K. M., Berry, D. C., Bigham, B. L., Bingham, R., Couto, T. B., Bottiger, B. W., Borra, V., Bray, J. E., Breckwoldt, J., Brooks, S. C., Buick, J., Callaway, C. W., Carlson, J. N., Cassan, P., Castren, M., Chang, W. -T., Charlton, N. P., Cheng, A., Chung, S. P., Considine, J., Couper, K., Dainty, K. N., Dawson, J. A., De Almeida, M. F., De Caen, A. R., Deakin, C. D., Drennan, I. R., Duff, J. P., Epstein, J. L., Escalante, R., Gazmuri, R. J., Gilfoyle, E., Granfeldt, A., Guerguerian, A. -M., Guinsburg, R., Hatanaka, T., Holmberg, M. J., Hood, N., Hosono, S., Hsieh, M. -J., Isayama, T., Iwami, T., Jensen, J. L., Kapadia, V., Kim, H. -S., Kleinman, M. E., Kudenchuk, P. J., Lang, E., Lavonas, E., Liley, H., Lim, S. H., Lockey, A., Lofgren, B., Ma, M. H. -M., Markenson, D., Meaney, P. A., Meyran, D., Mildenhall, L., Monsieurs, K. G., Montgomery, W., Morley, P. T., Morrison, L. J., Nadkarni, V. M., Nation, K., Neumar, R. W., Ng, K. -C., Nicholson, T., Nikolaou, N., Nishiyama, C., Nuthall, G., Ohshimo, S., Okamoto, D., O'Neil, B., Yong-Kwang Ong, G., Paiva, E. F., Parr, M., Pellegrino, J. L., Perkins, G. D., Perlman, J., Rabi, Y., Reis, A., Reynolds, J. C., Ristagno, G., Roehr, C. C., Sakamoto, T., Sandroni, Claudio, Schexnayder, S. M., Scholefield, B. R., Shimizu, N., Skrifvars, M. B., Smyth, M. A., Stanton, D., Swain, J., Szyld, E., Tijssen, J., Travers, A., Trevisanuto, D., Vaillancourt, C., Van De Voorde, P., Velaphi, S., Wang, T. -L., Weiner, G., Welsford, M., Woodin, J. A., Yeung, J., Nolan, J. P., Fran Hazinski, M., and Sandroni C. (ORCID:0000-0002-8878-2611)

Abstract

The International Liaison Committee on Resuscitation has initiated a continuous review of new, peer-reviewed, published cardiopulmonary resuscitation science. This is the third annual summary of the International Liaison Committee on Resuscitation International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations. It addresses the most recent published resuscitation evidence reviewed by International Liaison Committee on Resuscitation Task Force science experts. This summary addresses the role of cardiac arrest centers and dispatcher-assisted cardiopulmonary resuscitation, the role of extracorporeal cardiopulmonary resuscitation in adults and children, vasopressors in adults, advanced airway interventions in adults and children, targeted temperature management in children after cardiac arrest, initial oxygen concentration during resuscitation of newborns, and interventions for presyncope by first aid providers. Members from 6 International Liaison Committee on Resuscitation task forces have assessed, discussed, and debated the certainty of the evidence on the basis of the Grading of Recommendations, Assessment, Development, and Evaluation criteria, and their statements include consensus treatment recommendations. Insights into the deliberations of the task forces are provided in the Justification and Evidence to Decision Framework Highlights sections. The task forces also listed priority knowledge gaps for further research.

Published
2019

13. 2019 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations

Author

Soar, J., Maconochie, I., Wyckoff, M. H., Olasveengen, T. M., Singletary, E. M., Greif, R., Aickin, R., Bhanji, F., Donnino, M. W., Mancini, M. E., Wyllie, J. P., Zideman, D., Andersen, L. W., Atkins, D. L., Aziz, K., Bendall, J., Berg, K. M., Berry, D. C., Bigham, B. L., Bingham, R., Couto, T. B., Bottiger, B. W., Borra, V., Bray, J. E., Breckwoldt, J., Brooks, S. C., Buick, J., Callaway, C. W., Carlson, J. N., Cassan, P., Castren, M., Chang, W. -T., Charlton, N. P., Cheng, A., Chung, S. P., Considine, J., Couper, K., Dainty, K. N., Dawson, J. A., de Almeida, M. F., de Caen, A. R., Deakin, C. D., Drennan, I. R., Duff, J. P., Epstein, J. L., Escalante, R., Gazmuri, R. J., Gilfoyle, E., Granfeldt, A., Guerguerian, A. -M., Guinsburg, R., Hatanaka, T., Holmberg, M. J., Hood, N., Hosono, S., Hsieh, M. -J., Isayama, T., Iwami, T., Jensen, J. L., Kapadia, V., Kim, H. -S., Kleinman, M. E., Kudenchuk, P. J., Lang, E., Lavonas, E., Liley, H., Lim, S. H., Lockey, A., Lofgren, B., Ma, M. H. -M., Markenson, D., Meaney, P. A., Meyran, D., Mildenhall, L., Monsieurs, K. G., Montgomery, W., Morley, P. T., Morrison, L. J., Nadkarni, V. M., Nation, K., Neumar, R. W., Ng, K. -C., Nicholson, T., Nikolaou, N., Nishiyama, C., Nuthall, G., Ohshimo, S., Okamoto, D., O'Neil, B., Ong, G. Y. -K., Paiva, E. F., Parr, M., Pellegrino, J. L., Perkins, G. D., Perlman, J., Rabi, Y., Reis, A., Reynolds, J. C., Ristagno, G., Roehr, C. C., Sakamoto, T., Sandroni, C., Schexnayder, S. M., Scholefield, B. R., Shimizu, N., Skrifvars, M. B., Smyth, M. A., Stanton, D., Swain, J., Szyld, E., Tijssen, J., Travers, A., Trevisanuto, D., Vaillancourt, C., Van de Voorde, P., Velaphi, S., Wang, T. -L., Weiner, G., Welsford, M., Woodin, J. A., Yeung, J., Nolan, J. P., Hazinski, M. F., Sandroni C. (ORCID:0000-0002-8878-2611), Soar, J., Maconochie, I., Wyckoff, M. H., Olasveengen, T. M., Singletary, E. M., Greif, R., Aickin, R., Bhanji, F., Donnino, M. W., Mancini, M. E., Wyllie, J. P., Zideman, D., Andersen, L. W., Atkins, D. L., Aziz, K., Bendall, J., Berg, K. M., Berry, D. C., Bigham, B. L., Bingham, R., Couto, T. B., Bottiger, B. W., Borra, V., Bray, J. E., Breckwoldt, J., Brooks, S. C., Buick, J., Callaway, C. W., Carlson, J. N., Cassan, P., Castren, M., Chang, W. -T., Charlton, N. P., Cheng, A., Chung, S. P., Considine, J., Couper, K., Dainty, K. N., Dawson, J. A., de Almeida, M. F., de Caen, A. R., Deakin, C. D., Drennan, I. R., Duff, J. P., Epstein, J. L., Escalante, R., Gazmuri, R. J., Gilfoyle, E., Granfeldt, A., Guerguerian, A. -M., Guinsburg, R., Hatanaka, T., Holmberg, M. J., Hood, N., Hosono, S., Hsieh, M. -J., Isayama, T., Iwami, T., Jensen, J. L., Kapadia, V., Kim, H. -S., Kleinman, M. E., Kudenchuk, P. J., Lang, E., Lavonas, E., Liley, H., Lim, S. H., Lockey, A., Lofgren, B., Ma, M. H. -M., Markenson, D., Meaney, P. A., Meyran, D., Mildenhall, L., Monsieurs, K. G., Montgomery, W., Morley, P. T., Morrison, L. J., Nadkarni, V. M., Nation, K., Neumar, R. W., Ng, K. -C., Nicholson, T., Nikolaou, N., Nishiyama, C., Nuthall, G., Ohshimo, S., Okamoto, D., O'Neil, B., Ong, G. Y. -K., Paiva, E. F., Parr, M., Pellegrino, J. L., Perkins, G. D., Perlman, J., Rabi, Y., Reis, A., Reynolds, J. C., Ristagno, G., Roehr, C. C., Sakamoto, T., Sandroni, C., Schexnayder, S. M., Scholefield, B. R., Shimizu, N., Skrifvars, M. B., Smyth, M. A., Stanton, D., Swain, J., Szyld, E., Tijssen, J., Travers, A., Trevisanuto, D., Vaillancourt, C., Van de Voorde, P., Velaphi, S., Wang, T. -L., Weiner, G., Welsford, M., Woodin, J. A., Yeung, J., Nolan, J. P., Hazinski, M. F., and Sandroni C. (ORCID:0000-0002-8878-2611)

Abstract

The International Liaison Committee on Resuscitation has initiated a continuous review of new, peer-reviewed, published cardiopulmonary resuscitation science. This is the third annual summary of the International Liaison Committee on Resuscitation International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations. It addresses the most recent published resuscitation evidence reviewed by International Liaison Committee on Resuscitation Task Force science experts. This summary addresses the role of cardiac arrest centers and dispatcher-assisted cardiopulmonary resuscitation, the role of extracorporeal cardiopulmonary resuscitation in adults and children, vasopressors in adults, advanced airway interventions in adults and children, targeted temperature management in children after cardiac arrest, initial oxygen concentration during resuscitation of newborns, and interventions for presyncope by first aid providers. Members from 6 International Liaison Committee on Resuscitation task forces have assessed, discussed, and debated the certainty of the evidence on the basis of the Grading of Recommendations, Assessment, Development, and Evaluation criteria, and their statements include consensus treatment recommendations. Insights into the deliberations of the task forces are provided in the Justification and Evidence to Decision Framework Highlights sections. The task forces also listed priority knowledge gaps for further research.

Published
2019

14. Part 7: Neonatal Resuscitation

Author

Wyllie, J., Perlman, J. M., Kattwinkel, J., Wyckoff, M. H., Aziz, K., Guinsburg, R., Kim, H. -S., Liley, H. G., Mildenhall, L., Simon, W. M., Szyld, E., Tamura, M., Velaphi, S., Boyle, D. W., Byrne, S., Colby, C., Capetta, Davis, Ersdal, H. L., Escobedo, M. B., Feng, Q., de Almeida, M. F., Halamek, L. P., Isayama, T., Kapadia, V. S., Lee, H. C., Mcgowan, M., Mcmillan, D. D., Niermeyer, S., O'Donnell, C. P. F., Rabi, Y., Ringer, S. A., Singhal, N., Stenson, B. J., Strand, M. L., Sugiura, T., Trevisanuto, D., Udaeta, E., Weiner, G. M., and Yeo, C. L.

Subjects
Emergency Medical Services, medicine.medical_treatment, Diseases, Heart Massage, Incubators, Pregnancy, Neonatal Resuscitation Program, Respiratory function, Brain Damage, Airway Management, Chronic, Evidence-Based Medicine, Respiration, Delivery room, Survival Rate, Observational Studies as Topic, medicine.anatomical_structure, Cardiopulmonary resuscitation, Newborns, Cardiopulmonary Resuscitation, Humans, Infant, Newborn, Consensus, Practice Guidelines as Topic, Anesthesia, Artificial, Breathing, Female, Cardiology and Cardiovascular Medicine, Delivery, medicine.medical_specialty, Monitoring, Physiology (medical), medicine, Physiologic, Intensive care medicine, Premature, business.industry, Delivery Rooms, Brain Damage, Chronic, Delivery, Obstetric, Emergencies, Heart Arrest, Incubators, Infant, Infant Care, Infant, Premature, Infant, Premature, Diseases, Monitoring, Physiologic, Pregnancy Complications, Respiration, Artificial, Infant, Obstetric, Newborn, Pulmonary respiration, Blood pressure, Vascular resistance, business, Neonatal resuscitation
Abstract

Newborn Transition The transition from intrauterine to extrauterine life that occurs at the time of birth requires timely anatomic and physiologic adjustments to achieve the conversion from placental gas exchange to pulmonary respiration. This transition is brought about by initiation of air breathing and cessation of the placental circulation. Air breathing initiates marked relaxation of pulmonary vascular resistance, with considerable increase in pulmonary blood flow and increased return of now-well-oxygenated blood to the left atrium and left ventricle, as well as increased left ventricular output. Removal of the low-resistance placental circuit will increase systemic vascular resistance and blood pressure and reduce right-to-left shunting across the ductus arteriosus. The systemic organs must equally and quickly adjust to the dramatic increase in blood pressure and oxygen exposure. Similarly, intrauterine thermostability must be replaced by neonatal thermoregulation with its inherent increase in oxygen consumption. Approximately 85% of babies born at term will initiate spontaneous respirations within 10 to 30 seconds of birth, an additional 10% will respond during drying and stimulation, approximately 3% will initiate respirations after positive-pressure ventilation (PPV), 2% will be intubated to support respiratory function, and 0.1% will require chest compressions and/or epinephrine to achieve this transition.1–3 Although the vast majority of newborn infants do not require intervention to make these transitional changes, the large number of births worldwide means that many infants require some assistance to achieve cardiorespiratory stability each year. Newly born infants who are breathing or crying and have good tone immediately after birth must be dried and kept warm so as to avoid hypothermia. These actions can be provided with the baby lying on the mother’s chest and should not require separation of mother and baby. This does not preclude the need for clinical assessment of the baby. …

Published
2015
Full Text
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15. Tablet-based well-being check for the elderly: Development and evaluation of usability and acceptability

Author

Ray, P, Li, J, Ariani, A, Kapadia, V, Ray, P, Li, J, Ariani, A, and Kapadia, V

Abstract

Background: Many elderly people prefer to live at home independently. One of the major concerns raised by the family members is the safety and well-being of their elderly family members when living independently in a home environment. To address this issue, assistive technology solutions have been available in the market. Despite their availability and proliferation, these types of solutions are not popular with the elderly due to their intrusive nature, privacy-related issues, social stigma, and fear of losing human interaction. This study shares the experience in the development of a digital photo frame system that helps family members to check the well-being of the elderly, exploiting their desire to remain socially connected. Objectives: The aim of this study was to iteratively design, implement, and assess the usability, user friendliness, and acceptability of a tablet-based system to check the well-being of the elderly. Methods: Our study methodology comprises three separate stages: initial system development, contextual assessment, and comparative case study evaluation. Results: In the first stage, requirements were elicited from the elderly to design a well-being check prototype. In the second stage, areas for improvements (eg, privacy features) were identified. Also, additional features (such as medication prompts or food reminders) were suggested to help aged and health care service providers with effective but subtle monitoring of the elderly. These would lower their operating cost by reducing visits by care providers to the homes of the elderly. In the third stage, the results highlighted the difference (between users in India and Australia) in the levels of familiarity of the elderly with this technology. Some elderly participants at the Kalyani Institute for Study, Planning and Action for Rural Change, India latched onto this technology quickly while a few refused to use the system. However, in all cases, the support of family members was crucial for t

Published
2017

19. Systematic review and meta-analysis of optimal initial fraction of oxygen levels in the delivery room at <= 32weeks

Author

Saugstad OD, Aune D, Aguar M, Kapadia V, Finer N, and Vento M

Subjects
Oxygen, Resuscitation, Very low-birth-weight infants, Morbidity, Mortality
Abstract

Aim The optimal initial fraction of oxygen (iFiO2) for resuscitating/stabilising premature infants is not known. We aimed to study currently available information and provide guidelines regarding the iFiO2 levels needed to resuscitate/stabilise premature infants of 32weeks' gestation. Methods Our systematic review and meta-analysis studied the effects of low and high iFiO2 during the resuscitation/stabilisation of 677 newborn babies 32weeks' gestation. Results Ten randomised studies were identified covering 321 infants receiving low (0.21-0.30) iFiO2 levels and 356 receiving high (0.60-1.0) levels. Relative risk for mortality was 0.62 (95% CI: 0.37-1.04, I2=0%, pheterogeneity=0.88) for low versus high iFiO2 ; for bronchopulmonary dysplasia, it was 1.11 (95% CI: 0.73-1.68, I2=46%, pheterogeneity=0.06); and for intraventricular haemorrhage, it was 0.90 (95% CI: 0.53-1.53, I2=9%, pheterogeneity=0.36). Conclusion These data show that reduced mortality approached significance when a low iFiO2 (0.21-0.30) was used for initial stabilisation, compared to a high iFiO2 (0.60-1.0). There was no significant association for bronchopulmonary dysplasia or intraventricular haemorrhage when comparing low and high iFiO2. Based on present data, premature babies 32weeks' gestation in need of stabilisation in the delivery room should be given an iFiO2 of 0.21-0.30.

Published
2014

32. Inhibition of Mitochondrial Fission Protein Drp1 Ameliorates Myopathy in the D2-mdx Model of Duchenne Muscular Dystrophy.

Author

Rosen HG, Berger NJ, Hodge SN, Fujishiro A, Lourie J, Kapadia V, Linden MA, Jee E, Kim J, Kim Y, and Zou K

Abstract

Although current treatments for Duchenne Muscular Dystrophy (DMD) have proven to be effective in delaying myopathy, there remains a strong need to identify novel targets to develop additional therapies. Mitochondrial dysfunction is an early pathological feature of DMD. A fine balance of mitochondrial dynamics (fission and fusion) is crucial to maintain mitochondrial function and skeletal muscle health. Excessive activation of Dynamin-Related Protein 1 (Drp1)-mediated mitochondrial fission was reported in animal models of DMD. However, whether Drp1-mediated mitochondrial fission is a viable target for treating myopathy in DMD remains unknown. Here, we treated a D2-mdx model of DMD (9-10 weeks old) with Mdivi-1, a selective Drp1 inhibitor, every other day (i.p. injection) for 5 weeks. We demonstrated that Mdivi-1 effectively improved skeletal muscle strength and reduced serum creatine kinase concentration. Mdivi-1 treatment also effectively inhibited mitochondrial fission regulatory protein markers, Drp1(Ser616) phosphorylation and Fis1 in skeletal muscles from D2-mdx mice, which resulted in reduced content of damaged and fragmented mitochondria. Furthermore, Mdivi-1 treatment attenuated lipid peroxidation product, 4-HNE, in skeletal muscle from D2-mdx mice, which was inversely correlated with muscle grip strength. Finally, we revealed that Mdivi-1 treatment downregulated Alpha 1 Type I Collagen (Col1a1) protein expression, a marker of fibrosis, and Interleukin-6 (IL-6) mRNA expression, a marker of inflammation. In summary, these results demonstrate that inhibition of Drp1-mediated mitochondrial fission by Mdivi-1 is effective in improving muscle strength and alleviating muscle damage in D2-mdx mice. These improvements are associated with improved skeletal muscle mitochondrial integrity, leading to attenuated lipid peroxidation.

Published
2024
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33. Effect of interface dead space on the time taken to achieve changes in set FiO 2 during T-piece ventilation: is face mask the optimal interface for neonatal stabilisation?

Author

Gunnarsdottir K, Stenson BJ, Foglia EE, Kapadia V, Drevhammar T, and Donaldsson S

Abstract

Background: T-piece is recommended for respiratory support during neonatal stabilisation. Bench studies have shown a delay >30 s in achieving changes in fraction of inspired oxygen (FiO 2 ) at the airway when using the T-piece. Using a face mask adds dead space (DS) to the patient airway. We hypothesised that adding face mask to T-piece systems adversely affects the time required for a change in FiO 2 to reach the patient., Methods: Neopuff (Fisher and Paykel, Auckland, New Zealand) and rPAP (Inspiration Healthcare, Croydon, UK) were used to ventilate a test lung. DS equivalent to neonatal face masks was added between the T-piece and test lung. Additionally, rPAP was tested with nasal prongs. Time course for change in FiO 2 to be achieved at the airway was measured for increase (0.3-0.6) and decrease (1.0-0.5) in FiO 2 . Primary outcome was time to reach FiO 2 +/-0.05 of the set target. One-way analysis of variance was used to compare mean time to reach the primary outcome between different DS volumes., Results: In all experiments, the mean time to reach the primary outcome was significantly shorter for rPAP with prongs compared with Neopuff and rPAP with face mask DS (p<0.001). The largest observed difference occurred when testing a decrease in FiO 2 with 10 mL tidal volume (TV) without leakage (18.3 s for rPAP with prongs vs 153.4 s for Neopuff with face mask DS). The shortest observed time was 13.3 s when increasing FiO 2 with 10 mL TV with prongs with leakage and the longest time was 172.7 s when decreasing FiO 2 with 4 mL TV and added face mask DS without leak., Conclusion: There was a delay in achieving changes in oxygen delivery at the airway during simulated ventilation attributable to the mask volume. This delay was greatly reduced when using nasal prongs as an interface. This should be examined in clinical trials., Competing Interests: Competing interests: TD is one of the designers of the original rPAP respiratory support system., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Published
2024
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34. Initial Oxygen Concentration for the Resuscitation of Infants Born at Less Than 32 Weeks' Gestation: A Systematic Review and Individual Participant Data Network Meta-Analysis.

Author

Sotiropoulos JX, Oei JL, Schmölzer GM, Libesman S, Hunter KE, Williams JG, Webster AC, Vento M, Kapadia V, Rabi Y, Dekker J, Vermeulen MJ, Sundaram V, Kumar P, Kaban RK, Rohsiswatmo R, Saugstad OD, and Seidler AL

Subjects
Humans, Infant, Newborn, Infant, Premature, Gestational Age, Oxygen Saturation, Resuscitation methods, Oxygen Inhalation Therapy methods, Network Meta-Analysis, Oxygen administration & dosage
Abstract

Importance: Resuscitation with lower fractional inspired oxygen (FiO2) reduces mortality in term and near-term infants but the impact of this practice on very preterm infants is unclear., Objective: To evaluate the relative effectiveness of initial FiO2 on reducing mortality, severe morbidities, and oxygen saturations (SpO2) in preterm infants born at less than 32 weeks' gestation using network meta-analysis (NMA) of individual participant data (IPD)., Data Sources: MEDLINE, Embase, CENTRAL, CINAHL, ClinicalTrials.gov, and WHO ICTRP from 1980 to October 10, 2023., Study Selection: Eligible studies were randomized clinical trials enrolling infants born at less than 32 weeks' gestation comparing at least 2 initial oxygen concentrations for delivery room resuscitation, defined as either low (≤0.3), intermediate (0.5-0.65), or high (≥0.90) FiO2., Data Extraction and Synthesis: Investigators from eligible studies were invited to provide IPD. Data were processed and checked for quality and integrity. One-stage contrast-based bayesian IPD-NMA was performed with noninformative priors and random effects and adjusted for key covariates., Main Outcomes and Measures: The primary outcome was all-cause mortality at hospital discharge. Secondary outcomes were morbidities of prematurity and SpO2 at 5 minutes., Results: IPD were provided for 1055 infants from 12 of the 13 eligible studies (2005-2019). Resuscitation with high (≥0.90) initial FiO2 was associated with significantly reduced mortality compared to low (≤0.3) (odds ratio [OR], 0.45; 95% credible interval [CrI], 0.23-0.86; low certainty) and intermediate (0.5-0.65) FiO2 (OR, 0.34; 95% CrI, 0.11-0.99; very low certainty). High initial FiO2 had a 97% probability of ranking first to reduce mortality. The effects on other morbidities were inconclusive., Conclusions and Relevance: High initial FiO2 (≥0.90) may be associated with reduced mortality in preterm infants born at less than 32 weeks' gestation compared to low initial FiO2 (low certainty). High initial FiO2 is possibly associated with reduced mortality compared to intermediate initial FiO2 (very low certainty) but more evidence is required.

Published
2024
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36. Delivery Room Handling of the Newborn: Filling the Gaps.

Author

Saugstad OD, Kapadia V, and Vento M

Subjects
Humans, Infant, Newborn, Algorithms, Developing Countries, Practice Guidelines as Topic, American Heart Association, United States, Evidence-Based Medicine, Resuscitation methods, Delivery Rooms
Abstract

Background: Newborn resuscitation algorithms have since the turn of the century been more evidence-based. In this review, we discuss the development of American Heart Association (AHA) and the International Liaison Committee on Resuscitation (ILCOR)'s algorithm for newborn resuscitation from 1992-2024. We have also aimed to identify the remaining gaps in non-evidenced practice., Summary: Of the 22 procedures reviewed in the 2020 ILCOR recommendations, the evidence was either low, very low, or non-existing. The strength of recommendation is weak or non-existing for most topics discussed. Several knowledge gaps are also summarized. The special challenge for low- and middle-income countries (LMIC) is discussed., Key Messages: Newborn resuscitation is still not evidence-based, although great progress has been achieved the recent years. We have identified several knowledge gaps which should be prioritized in future research. The challenge of obtaining evidence-based knowledge from LMIC should be focused on in future research., (© 2024 The Author(s). Published by S. Karger AG, Basel.)

Published
2024
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37. TeleNICU: Extending the reach of level IV care and optimizing the triage of patient transfers.

Author

Jagarapu J, Kapadia V, Mir I, Kakkilaya V, Carlton K, Fokken M, Brown S, Hall-Barrow J, and Savani RC

Subjects
Infant, Infant, Newborn, Child, Humans, Triage, Patient Transfer, Referral and Consultation, Intensive Care Units, Neonatal, Telemedicine methods
Abstract

Background: The use of telemedicine to provide care for critically ill newborn infants has significantly evolved over the last two decades. Children's Health System of Texas and University of Texas Southwestern Medical Center established TeleNICU, the first teleneonatology program in Texas., Objective: To evaluate the effectiveness of Tele Neonatal Intensive Care Unit (TeleNICU) in extending quaternary neonatal care to more rural areas of Texas., Materials and Methods: We conducted a retrospective review of TeleNICU consultations from September 2013 to October 2018. Charts were reviewed for demographic data, reasons for consultation, and consultation outcomes. Diagnoses were classified as medical, surgical, or combined. Consultation outcomes were categorized into transferred or retained. Transport cost savings were estimated based on the distance from the hub site and the costs for ground transportation., Results: TeleNICU had one hub (Level IV) and nine spokes (Levels I-III) during the study period. A total of 132 direct consultations were completed during the study period. Most consultations were conducted with Level III units (81%) followed by level I (13%) and level II (6%) units. Some common diagnoses included prematurity (57%), respiratory distress (36%), congenital anomalies (25%), and neonatal surgical emergencies (13%). For all encounters, 54% of the patients were retained at the spoke sites, resulting in an estimated cost savings of USD0.9 million in transport costs alone. The likelihood of retention at spoke sites was significantly higher for medical diagnoses compared to surgical diagnoses (89% vs. 11%)., Conclusion: Telemedicine effectively expands access to quaternary neonatal care for more rural communities, helps in the triage of neonatal transfers, promotes family centered care, and significantly reduces health care costs., Competing Interests: Declaration of conflicting interestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Published
2024
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38. Laryngeal mask use during neonatal resuscitation at birth: A United States-based survey of neonatal resuscitation program providers and instructors.

Author

Foglia EE, Shah BA, DeShea L, Lander K, Kamath-Rayne BD, Herrick HM, Zaichkin J, Lee S, Bonafide C, Song C, Hallford G, Lee HC, Kapadia V, Leone T, Josephsen J, Gupta A, Strand ML, Beasley WH, and Szyld E

Abstract

Aim: Neonatal resuscitation guidelines promote the laryngeal mask (LM) interface for positive pressure ventilation (PPV), but little is known about how the LM is used among Neonatal Resuscitation Program (NRP) Providers and Instructors. The study aim was to characterize the training, experience, confidence, and perspectives of NRP Providers and Instructors regarding LM use during neonatal resuscitation at birth., Methods: A voluntary anonymous survey was emailed to all NRP Providers and Instructors. Survey items addressed training, experience, confidence, and barriers for LM use during resuscitation. Associations between respondent characteristics and outcomes of both LM experience and confidence were assessed using logistic regression., Results: Between 11/7/22-12/12/22, there were 5,809 survey respondents: 68% were NRP Providers, 55% were nurses, and 87% worked in a hospital setting. Of these, 12% had ever placed a LM during newborn resuscitation, and 25% felt very or completely confident using a LM. In logistic regression, clinical or simulated hands-on training, NRP Instructor role, professional role, and practice setting were all associated with both LM experience and confidence.The three most frequently identified barriers to LM use were insufficient experience (46%), preference for other interfaces (25%), and failure to consider the LM during resuscitation (21%). One-third (33%) reported that LMs are not available where they resuscitate newborns., Conclusion: Few NRP providers and instructors use the LM during neonatal resuscitation. Strategies to increase LM use include hands-on clinical training, outreach promoting the advantages of the LM compared to other interfaces, and improving availability of the LM in delivery settings., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2023 The Authors.)

Published
2023
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40. Bridging the gap: Palliative care integration into survivorship care.

Author

Morgan B, Kapadia V, Crawford L, Martin S, and McCollom J

Subjects
Humans, Palliative Care, Survivorship, Prospective Studies, Research Design, Cancer Survivors, Neoplasms therapy, Neoplasms psychology
Abstract

As the number of cancer survivors grows, there is an increasing need for comprehensive care to address the unique physical, psychological, and social needs of this population. Palliative care (PC) integration within survivorship care offers a promising model of care, however, there is no comprehensive review of literature to guide clinical practice. This manuscript presents a scoping review of the research literature on models of care that integrate PC with survivorship care, as well as a detailed description of an exemplar clinical model. We identified 20 articles that described various models of survivorship care with integrated PC, highlighting the diversity of approaches and the multidisciplinary nature of interventions. Few studies reported outcomes but those that did demonstrated improvements in pain, self-efficacy, depression, function, and documentation of advance care planning. The evidence base remains limited, indicating the need for further research in this area with a focus on exploring outcomes using prospective experimental designs. Future clinical practice and research should explore sustainable payment models and the implementation of integrated survivorship care in value-based payment systems., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Inc. All rights reserved.)

Published
2023
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41. A Study of Role of Medical Thoracoscopy in Undiagnosed Pleural Effusion.

Author

Kapadia V, Jindal S, Patel P, and Tripathi S

Subjects
Humans, Retrospective Studies, Pleura pathology, Thoracoscopy adverse effects, Thoracoscopy methods, Pleural Effusion, Malignant diagnosis, Pleural Effusion diagnosis, Pleural Effusion etiology, Pleural Effusion pathology
Abstract

Aim and Objectives: b/pulli>To know the diagnostic yield of pleuroscopy (medical thoracoscopy) in cases of pleural effusions which remain undiagnosed after routine initial investigations.lili>To notice the different gross pleuroscopic findings during the procedure.lili>To observe various histopathological reports of pleural biopsy taken through medical thoracoscopy.lili>To know the various complications of pleuroscopy in patients undergoing this procedure.li/ulp!, Materials and Methods: A total of 56 patients having undiagnosed pleural effusion were taken for study after informed written consent. All patients underwent medical thoracoscopy. The clinical, demographic, and radiological profile of patients was recorded. Gross pleuroscopic findings and histopathological reports of the pleural biopsy were noted. All patients were observed for any complications that occurred during or after the procedure., Result: Diagnostic yield of thoracoscopy in the present study was 91.07% (malignant pleural effusion 75% and tuberculous pleuritis 12.5%). Adenocarcinoma was the commonest malignancy in 60.71% of patients amongst malignant pleural effusion in the present study. Very few complications were recorded. The most common postprocedure complication was subcutaneous emphysema (12.5%) followed by pneumothorax (10.78%)., Conclusion: Thoracoscopy gives excellent diagnostic yield in undiagnosed pleural effusion without major complications, and should be utilized wherever feasible., (© Journal of the Association of Physicians of India 2011.)

Published
2023
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42. Recommended Guideline for Uniform Reporting of Neonatal Resuscitation: The Neonatal Utstein Style.

Author

Foglia EE, Davis PG, Guinsburg R, Kapadia V, Liley HG, Rüdiger M, Schmölzer GM, Strand ML, Wyckoff MH, Wyllie J, and Weiner GM

Subjects
Humans, Infant, Newborn, Bradycardia therapy, Heart Arrest therapy, Respiratory Distress Syndrome, Newborn therapy, Cardiopulmonary Resuscitation, Research Report standards, Guidelines as Topic
Abstract

Clinical research on neonatal resuscitation has accelerated over recent decades. However, an important methodologic limitation is that there are no standardized definitions or reporting guidelines for neonatal resuscitation clinical studies. To address this, the International Liaison Committee on Resuscitation Neonatal Life Support Task Force established a working group to develop the first Utstein-style reporting guideline for neonatal resuscitation. The working group modeled this approach on previous Utstein-style guidelines for other populations. This reporting guideline focuses on resuscitation of newborns immediately after birth for respiratory failure, bradycardia, severe bradycardia, or cardiac arrest. We identified 7 relevant domains: setting, patient, antepartum, birth/preresuscitation, resuscitation process, postresuscitation process, and outcomes. Within each domain, relevant data elements were identified as core versus supplemental. Core data elements should be collected and reported for all neonatal resuscitation studies, while supplemental data elements may be collected and reported using standard definitions when possible. The Neonatal Utstein template includes both core and supplemental elements across the 7 domains, and the associated Data Table provides detailed information and reporting standards for each data element. The Neonatal Utstein reporting guideline is anticipated to assist investigators engaged in neonatal resuscitation research by standardizing data definitions. The guideline will facilitate data pooling in meta-analyses, enhancing the strength of neonatal resuscitation treatment recommendations and subsequent guidelines., (Copyright © 2023 by the American Academy of Pediatrics.)

Published
2023
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44. A Narrative Review of the Rationale for Conducting Neonatal Emergency Studies with a Waived or Deferred Consent Approach.

Author

Katheria A, Schmölzer GM, Janvier A, Kapadia V, Saugstad OD, Vento M, Kushnir A, Tracy M, Rich W, and Oei JL

Subjects
Humans, Infant, Newborn, Infant, Emergency Medicine, Informed Consent, Clinical Trials as Topic
Abstract

Emergency research studies are high-stakes studies that are usually performed on the sickest patients, where many patients or guardians have no opportunity to provide full informed consent prior to participation. Many emergency studies self-select healthier patients who can be informed ahead of time about the study process. Unfortunately, results from such participants may not be informative for the future care of sicker patients. This inevitably creates waste and perpetuates uninformed care and continued harm to future patients. The waiver or deferred consent process is an alternative model that may be used to enroll sick patients who are unable to give prospective consent to participate in a study. However, this process generates vastly different stakeholder views which have the potential to create irreversible impediments to research and knowledge. In studies involving newborn infants, consent must be sought from a parent or guardian, and this adds another layer of complexity to already fraught situations if the infant is very sick. In this manuscript, we discuss reasons why consent waiver or deferred consent processes are vital for some types of neonatal research, especially those occurring at and around the time of birth. We provide a framework for conducting neonatal emergency research under consent waiver that will ensure the patient's best interests without compromising ethical, beneficial, and informative knowledge acquisition to improve the future care of sick newborn infants., (© 2023 S. Karger AG, Basel.)

Published
2023
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45. Chest compressions and medications during neonatal resuscitation.

Author

Ramachandran S, Bruckner M, Kapadia V, and Schmölzer GM

Subjects
Humans, Infant, Newborn, Thorax, Cardiopulmonary Resuscitation methods
Abstract

Prolonged resuscitation in neonates, although quite rare, may occur in response to profound intractable bradycardia as a result of asphyxia. In these instances, chest compressions and medications may be necessary to facilitate return of spontaneous circulation. While performing chest compressions, the two thumb method is preferred over the two finger technique, although several newer approaches are under investigation. While the ideal compression to ventilation ratio is still uncertain, a 3:1 ratio remains the recommendation by the Neonatal Resuscitation Program. Use of feedback mechanisms to optimize neonatal cardiopulmonary resuscitation (CPR) show promise and are currently under investigation. While performing optimal cardiac compressions to pump blood, use of medications to restore spontaneous circulation will likely be necessary. Current recommendations are that epinephrine, an endogenous catecholamine be used preferably intravenously or by intraosseous route, with the dose repeated every 3-5 minutes until return of spontaneous circulation. Finally, while the need for volume replacement is rare, it may be considered in instances of acute blood loss or poor response to resuscitation., Competing Interests: Conflict of Interest None, (Copyright © 2022. Published by Elsevier Inc.)

Published
2022
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47. Neurodevelopmental outcomes of preterm infants after randomisation to initial resuscitation with lower (FiO 2 < 0.3) or higher (FiO 2 > 0.6) initial oxygen levels. An individual patient meta-analysis.

Author

Oei JL, Kapadia V, Rabi Y, Saugstad OD, Rook D, Vermeulen MJ, Boronat N, Thamrin V, Tarnow-Mordi W, Smyth J, Wright IM, Lui K, van Goudoever JB, Gebski V, and Vento M

Subjects
Child, Gestational Age, Humans, Infant, Infant, Newborn, Middle Aged, Oxygen, Resuscitation, Infant, Premature, Infant, Premature, Diseases therapy
Abstract

Objective: To determine the effects of lower (≤0.3) versus higher (≥0.6) initial fractional inspired oxygen (FiO 2 ) for resuscitation on death and/or neurodevelopmental impairment (NDI) in infants <32 weeks' gestation., Design: Meta-analysis of individual patient data from three randomised controlled trials., Setting: Neonatal intensive care units., Patients: 543 children <32 weeks' gestation., Intervention: Randomisation at birth to resuscitation with lower (≤0.3) or higher (≥0.6) initial FiO 2 ., Outcome Measures: Primary: death and/or NDI at 2 years of age.Secondary: post-hoc non-randomised observational analysis of death/NDI according to 5-minute oxygen saturation (SpO 2 ) below or at/above 80%., Results: By 2 years of age, 46 of 543 (10%) children had died. Of the 497 survivors, 84 (17%) were lost to follow-up. Bayley Scale of Infant Development (third edition) assessments were conducted on 377 children. Initial FiO 2 was not associated with difference in death and/or disability (difference (95% CI) -0.2%, -7% to 7%, p=0.96) or with cognitive scores <85 (2%, -5% to 9%, p=0.5). Five-minute SpO 2 >80% was associated with decreased disability/death (14%, 7% to 21%) and cognitive scores >85 (10%, 3% to 18%, p=0.01). Multinomial regression analysis noted decreased death with 5-minute SpO 2 ≥80% (odds (95% CI) 09.62, 0.98 to 0.96) and gestation (0.52, 0.41 to 0.65), relative to children without death or NDI., Conclusion: Initial FiO 2 was not associated with difference in risk of disability/death at 2 years in infants <32 weeks' gestation but CIs were wide. Substantial benefit or harm cannot be excluded. Larger randomised studies accounting for patient differences, for example, gestation and gender are urgently needed., Competing Interests: Competing interests: YR has patents for technology to guide oxygen titration during newborn resuscitation. He did not contribute to any aspects of the manuscript related to the targeting of oxygen saturation., (© Author(s) (or their employer(s)) 2022. No commercial re-use. See rights and permissions. Published by BMJ.)

Published
2022
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48. Decreasing delivery room CPAP-associated pneumothorax at ≥35-week gestational age.

Author

Stocks EF, Jaleel M, Smithhart W, Burchfield PJ, Thomas A, Mangona KLM, Kapadia V, Wyckoff M, Kakkilaya V, Brenan S, Brown LS, Clark C, Nelson DB, and Brion LP

Subjects
Continuous Positive Airway Pressure adverse effects, Delivery Rooms, Female, Gestational Age, Humans, Infant, Newborn, Pregnancy, Retrospective Studies, Pneumothorax etiology, Respiratory Distress Syndrome, Newborn therapy
Abstract

Objective: We previously reported an increase in pneumothorax after implementing delivery room (DR) continuous positive airway pressure (CPAP) for labored breathing or persistent cyanosis in ≥35-week gestational age (GA) neonates unexposed to DR-positive pressure ventilation (DR-PPV). We hypothesized that pneumothorax would decrease after de-implementing DR-CPAP in those unexposed to DR-PPV or DR-O 2 supplementation (DR-PPV/O 2 )., Study Design: In a retrospective cohort excluding DR-PPV the primary outcome was DR-CPAP-related pneumothorax (1st chest radiogram, 1st day of life). In a subgroup treated by the resuscitation team and admitted to the NICU, the primary outcome was DR-CPAP-associated pneumothorax (1st radiogram, no prior PPV) without DR-PPV/O 2 ., Results: In the full cohort, occurrence of DR-CPAP-related pneumothorax decreased after the intervention (11.0% vs 6.0%, P < 0.001). In the subgroup, occurrence of DR-CPAP-associated pneumothorax decreased after the intervention (1.4% vs. 0.06%, P < 0.001)., Conclusion: The occurrence of CPAP-associated pneumothorax decreased after avoiding DR-CPAP in ≥35-week GA neonates without DR-PPV/O 2 ., (© 2022. The Author(s), under exclusive licence to Springer Nature America, Inc.)

Published
2022
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50. Electrocardiogram for heart rate evaluation during preterm resuscitation at birth: a randomized trial.

Author

Abbey NV, Mashruwala V, Weydig HM, Steven Brown L, Ramon EL, Ibrahim J, Mir IN, Wyckoff MH, and Kapadia V

Subjects
Electrocardiography, Heart Rate, Humans, Infant, Infant, Newborn, Intermittent Positive-Pressure Ventilation, Infant, Premature, Resuscitation
Abstract

Background: Although electrocardiogram (ECG) can detect heart rate (HR) faster compared to pulse oximetry, it remains unknown if routine use of ECG for delivery room (DR) resuscitation reduces the time to stabilization in preterm infants., Methods: Neonates <31 weeks' gestation were randomized to either an ECG-displayed or an ECG-blinded HR assessment in the DR. HR, oxygen saturation, resuscitation interventions, and clinical outcomes were compared., Results: During the study period, 51 neonates were enrolled. The mean gestational age in both groups was 28 ± 2 weeks. The time to stabilization, defined as the time from birth to achieve HR ≥100 b.p.m., as well as oxygen saturation within goal range, was not different between the ECG-displayed and the ECG-blinded groups [360 (269, 435) vs 345 (240, 475) s, p = 1.00]. There was also no difference in the time to HR ≥100 b.p.m. [100 (75, 228) vs 138 (88, 220) s, p = 0.40] or duration of positive pressure ventilation (PPV) [345 (120, 558) vs 196 (150, 273) s, p = 0.36]. Clinical outcomes were also similar between groups., Conclusions: Although feasible and safe, the use of ECG in the DR during preterm resuscitation did not reduce time to stabilization., Impact: Although feasible and apparently safe, routine use of the ECG in the DR did not decrease time to HR >100 b.p.m., time to stabilization, or use of resuscitation interventions such as PPV for preterm infants <31 weeks' gestational age. This article adds to the limited randomized controlled trial evidence regarding the impact of routine use of ECG during preterm resuscitation on DR clinical outcomes. Such evidence is important when considering recommendations for routine use of the ECG in the DR worldwide as such a recommendation comes with a significant cost burden., (© 2021. The Author(s), under exclusive licence to the International Pediatric Research Foundation, Inc.)

Published
2022
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