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A review of different resuscitation platforms during delayed cord clamping
Anup Katheria1, Henry C Lee2, Ronny Knol3
1Neonatal Research Institute, Sharp Mary Birch Hospital, San Diego, CA, USA. anup.katheria@sharp.com.
Insights
Delaying umbilical cord clamping offers benefits for newborns. New research explores resuscitation techniques for non-vigorous infants with an intact cord, reviewing current devices and trials.
Area of Science:
- Neonatal resuscitation
- Perinatal medicine
- Pediatric physiology
Background:
- Delayed umbilical cord clamping (DUCC) is proven beneficial for term and preterm infants.
- DUCC improves infant mortality and developmental outcomes.
- Resuscitation of non-vigorous newborns typically involves immediate cord clamping, excluding them from DUCC benefits.
Purpose of the Study:
- To review devices and methods for resuscitating non-vigorous infants with an intact umbilical cord.
- To present the benefits and limitations of intact cord resuscitation equipment.
- To discuss ongoing and published trials evaluating these novel approaches.
Main Methods:
- Systematic review of existing literature on intact cord resuscitation.
- Analysis of data from published trials and ongoing studies.
- Evaluation of specialized resuscitation devices designed for intact cord procedures.
Main Results:
- Evidence suggests physiological benefits of intact cord resuscitation in human and animal models.
- Several devices have been developed or are in use for this purpose.
- Ongoing trials are crucial to further establish safety and efficacy.
Conclusions:
- Intact cord resuscitation is a developing field with potential to extend DUCC benefits to all infants.
- Further research and clinical trials are needed to optimize techniques and devices.
- This approach may revolutionize neonatal resuscitation practices.
Abstract:
There is a large body of evidence demonstrating that delaying clamping of the umbilical cord provides benefits for term and preterm infants. These benefits include reductions in mortality in preterm infants and improved developmental scores at 4 years of age in term infants. However, non-breathing or non-vigorous infants at birth are excluded due to the perceived need for immediate resuscitation. Recent studies have demonstrated early physiological benefits in both human and animal models if resuscitation is performed with an intact cord, but this is still an active area of research. Given the large number of ongoing and planned trials, we have brought together an international group that have been intimately involved in the development or use of resuscitation equipment designed to be used while the cord is still intact. In this review, we will present the benefits and limitations of devices that have been developed or are in use. Published trials or ongoing studies using their respective devices will also be reviewed.
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