Neonatal resuscitation

Neonatal resuscitation techniques are evolving. More sophisticated methods of monitoring have emerged and current practices have been challenged. It is recognised that most newborns will require only gentle assistance to facilitate the transition from intrauterine life. The routine use of suction and oxygen supplementation is no longer recommended and the effectiveness of current methods of delivering ventilatory support has been questioned. The importance of effective use of masks and optimising tidal ventilation rather than pressure generation is emphasised. Newer oximetry technologies and the routine use of capnography may facilitate clinical assessment even during active resuscitation. Methods of warming infants have become increasingly effective and the use of servo-control is emphasised to prevent overheating. Evidence to support therapeutic hypothermia for the birth-asphyxiated baby is solid and cooling should be considered a standard of care. The next revision of the International Liason Committee on Resuscitation (ILCOR) Guidelines is eagerly awaited in 2010.