[Controversies in neonatal resuscitation]

Area of Science:

• Neonatology
• Pediatric Critical Care

Background:

• Newborn resuscitation procedures are critical for infant survival.
• Several aspects of current resuscitation practices remain controversial.

Purpose of the Study:

• To outline the primary controversies in newborn resuscitation.
• To identify areas requiring further investigation and consensus.

Main Methods:

• Systematic review of medical literature (MEDLINE, LILACS, Cochrane Library).
• Analysis of abstracts from Pediatric Research.
• Keywords: resuscitation, asphyxia neonatorum, newborn infant.

Main Results:

• Effectiveness of hypothermia and ambient air ventilation is under investigation.
• Reducing ventilation-induced lung injury (barotrauma, volutrauma) in preterm infants is challenging.
• Disagreement exists on endotracheal intubation indications for extremely low birth weight infants, especially without surfactant therapy.
• Uncertainty persists regarding optimal adrenaline dosage and sodium bicarbonate use, particularly in preterm infants.
• Ethical dilemmas involve resuscitation decisions based on gestational age, birth weight, and congenital anomalies.

Conclusions:

• Current newborn resuscitation therapies require further validation.
• High-quality evidence from animal studies and randomized controlled trials with long-term infant follow-up is needed to guide practice changes.