Cerebral perfusion and metabolism with mild hypercapnia vs. normocapnia in a porcine post cardiac arrest model with and without targeted temperature management.

Aim: To determine whether targeting mild hypercapnia (PaCO 7 kPa) would yield improved cerebral blood flow and metabolism compared to normocapnia (PaCO 5 kPa) with and without targeted temperature management to 33 °C (TTM33) in a porcine post-cardiac arrest model.

Methods: 39 pigs were resuscitated after 10 minutes of cardiac arrest using cardiopulmonary bypass and randomised to TTM33 or no-TTM, and hypercapnia or normocapnia. TTM33 was managed with intravasal cooling.

Lung tissue injury and hemodynamic effects of ventilations synchronized or unsynchronized to continuous chest compressions in a porcine cardiac arrest model.

Aim: Compare lung injury and hemodynamic effects in synchronized ventilations (between two chest compressions) vs. unsynchronized ventilations during cardiopulmonary resuscitation (CPR) in a porcine model of cardiac arrest.

Methods: Twenty pigs were randomized to either synchronized or unsynchronized group.

Effect of a positive pressure ventilation-refresher program on ventilation skill performance during simulated newborn resuscitation.

Aim: Clinical staff highly proficient in neonatal resuscitation are essential to ensure prompt, effective positive pressure ventilation (PPV) for infants that do not breathe spontaneously after birth. However, it is well-documented that resuscitation competency is transient after standard training. We hypothesized that brief, repeated PPV psychomotor skill refresher training would improve PPV performance for newborn care nurses.

Cerebral perfusion and metabolism with mean arterial pressure 90 vs. 60 mmHg in a porcine post cardiac arrest model with and without targeted temperature management.

Aim: To determine whether targeting a mean arterial pressure of 90 mmHg (MAP90) would yield improved cerebral blood flow and less ischaemia compared to MAP 60 mmHg (MAP60) with and without targeted temperature management at 33 °C (TTM33) in a porcine post-cardiac arrest model.

Methods: After 10 min of cardiac arrest, 41 swine of either sex were resuscitated until return of spontaneous circulation (ROSC). They were randomised to TTM33 or no-TTM, and MAP60 or MAP90; yielding four groups.

[Newborn resuscitation and support of transition of infants at birth].

The European Resuscitation Council has produced these newborn life support guidelines, which are based on the International Liaison Committee on Resuscitation (ILCOR) 2020 Consensus on Science and Treatment Recommendations (CoSTR) for Neonatal Life Support. The guidelines cover the management of the term and preterm infant. The topics covered include an algorithm to aid a logical approach to resuscitation of the newborn, factors before delivery, training and education, thermal control, management of the umbilical cord after birth, initial assessment and categorisation of the newborn infant, airway and breathing and circulation support, communication with parents, considerations when withholding and discontinuing support.

European Resuscitation Council Guidelines 2021: Newborn resuscitation and support of transition of infants at birth.

The European Resuscitation Council has produced these newborn life support guidelines, which are based on the International Liaison Committee on Resuscitation (ILCOR) 2020 Consensus on Science and Treatment Recommendations (CoSTR) for Neonatal Life Support. The guidelines cover the management of the term and preterm infant. The topics covered include an algorithm to aid a logical approach to resuscitation of the newborn, factors before delivery, training and education, thermal control, management of the umbilical cord after birth, initial assessment and categorisation of the newborn infant, airway and breathing and circulation support, communication with parents, considerations when withholding and discontinuing support.

Suboptimal heart rate assessment and airway management in infants receiving delivery room chest compressions: a quality assurance project.

Objective: In a previous audit, we demonstrated poor compliance with the neonatal resuscitation algorithm. Training can improve guideline compliance and performance. We aimed to prospectively collect detailed data on delivery room resuscitations to identify needs for educational interventions.

Video performance-debriefings and ventilation-refreshers improve quality of neonatal resuscitation.

Aim: Providers caring for newly born infants require skills and knowledge to initiate prompt and effective positive pressure ventilation (PPV) if the newborn does not breathe spontaneously after birth. We hypothesized implementation of high frequency/short duration deliberate practice training and post event video-based debriefings would improve process of care and decreases time to effective spontaneous respiration.

Methods: Pre- and post-interventional quality study performed at two Norwegian university hospitals.

Incidence and characteristics of positive pressure ventilation delivered to newborns in a US tertiary academic hospital.

Introduction: The Neonatal Resuscitation Program (NRP) guidelines recommend positive pressure ventilation (PPV) in the first 60s of life to support perinatal transition in non-breathing newborns. Our aim was to describe the incidence and characteristics of newborn PPV using real-time observation in the delivery unit.

Methods: Prospective, observational, quality improvement study conducted at a tertiary academic hospital.

Targeted simulation and education to improve cardiac arrest recognition and telephone assisted CPR in an emergency medical communication centre.

Aim: Recognition of cardiac arrest and prompt activation time by emergency medical dispatch are key process measures that have been associated with improved survival after out-of-hospital cardiac arrest (OHCA). The aim of this study is to improve recognition of OHCA and time to initiation of telephone assisted chest compressions in an emergency medical communication centre (EMCC).

Methods: A prospective, interventional study implementing targeted interventions in an EMCC.

Ventilation fraction during the first 30s of neonatal resuscitation.

Aim: Approximately 5% of newborns receive positive pressure ventilation (PPV) for successful transition. Guidelines urge providers to ensure effective PPV for 30-60s before considering chest compressions and intravenous therapy. Pauses in this initial PPV may delay recovery of spontaneous respiration.

Incidence of Newborn Stabilization and Resuscitation Measures and Guideline Compliance during the First Minutes of Life in Norway.

Background: Most newborns manage the transition from intra- to extrauterine life without interventions, yet neonatal morbidity caused by failure of transition remains an important health problem.

Objective: To determine the incidence of neonatal stabilization and resuscitation measures and guideline compliance during the first minutes after birth.

Methods: This is a prospective, observational study of all births in three Norwegian hospitals.