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The Changing Landscape in Supporting Preterm Infants at Birth
Arjan B Te Pas1, Stuart B Hooper2,3, Janneke Dekker4,2
1Department of Pediatrics, Leiden University Medical Center, Leiden, The Netherlands, a.b.te_pas@lumc.nl.
Neonatology
|April 12, 2019
Summary
Immediate umbilical cord clamping may hinder noninvasive ventilation for preterm infants. Postponing clamping and stimulating spontaneous breathing could improve infant stabilization and respiratory support.
Area of Science:
- Neonatal Physiology
- Respiratory Support
- Perinatal Medicine
Background:
- Noninvasive ventilation (NIV) is standard for preterm infants.
- Immediate umbilical cord clamping is common practice for stabilization.
- Current understanding of early interventions' physiological impact is limited.
Purpose of the Study:
- To review recent findings on interventions during infant transition at birth.
- To highlight how laryngeal closure affects NIV efficacy.
- To explore the benefits of delayed cord clamping (DCC).
Main Methods:
- Review of experimental animal data.
- Analysis of human physiological measurements at birth.
- Synthesis of current scientific literature on neonatal stabilization.
Main Results:
- Laryngeal closure in apneic infants can negate NIV effectiveness.
- Stimulating spontaneous breathing may improve NIV success.
- Delayed cord clamping can mitigate adverse hemodynamic and oxygenation changes.
Conclusions:
- Established practices for preterm infant stabilization need re-evaluation.
- New approaches focusing on spontaneous breathing and DCC show promise.
- These "game changers" could revolutionize neonatal transition care.
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