Different chest compression techniques during neonatal resuscitation - a cluster randomized trial
BACKGROUND: About 0.1% of term infants and up to 15% of preterm infants receive chest compression at birth, which will result in approximately 1 million newborn deaths annually worldwide. Infants receiving chest compression have a high incidence of mortality or long-term neurologic morbidity including moderate-to-severe disability. The poor prognosis associated with receiving chest compression in the delivery room raises questions as to whether improved cardiopulmonary resuscitation methods specifically tailored to the newborn could improve outcomes.
GAP: The inability to predict which newborns need cardiopulmonary resuscitation, and the infrequent use of cardiopulmonary resuscitation in the delivery room have limited neonatologists’ ability to perform rigorous clinical studies to determine the best method for delivering chest compression to newborn infants. Studies are needed to determine the optimal method for improving hemodynamics and recovery during neonatal resuscitation.
HYPOTHESIS: In newborn infants requiring cardiopulmonary resuscitation, does chest compression during sustained inflation compared to 3:1 compression to ventilation ratio improves return of spontaneous circulation?
METHODS: This will be cluster, randomized, controlled, multi-center phase clinical trial in 218 preterm and term newborn infants requiring chest compression in the delivery room. Our primary outcome measure will be time to achieve return of spontaneous circulation.
IMPACT: Although results will not be available prior 2021-2022, we anticipate that chest compression during sustained inflation has the potential to significantly improve return of spontaneous circulation and survival. If our results are validated, clinicians in delivery rooms around the world could adopt this approach, which could benefit many babies each year.
Website Link: http://www.surv1ve.org