Neonatal Asphyxia and Resuscitation

Dear Colleagues,

Most newborns successfully make the transition from fetal to neonatal life without help. From 10 to 20% of newborn infants (13–26 million worldwide) need respiratory support. Unfortunately, 0.1% of term infants and 10–15% of preterm infants (2-3 million worldwide) in the delivery room need cardiopulmonary resuscitation (CPR), defined as chest compression, 100% oxygen, and/or epinephrine. Despite receiving CPR, ~1 million of these newborns die worldwide each year.

Newborn infants receiving extensive CPR in the delivery room have a high incidence of mortality (41%) and short-term neurologic morbidity (e.g., 57% hypoxic-ischemic encephalopathy and seizures). Further, newborns receiving CPR but with no signs of life at 10 minutes after birth had an 83% mortality rate, and 93% of survivors will have moderate to severe disability. The poor prognosis associated with receiving CPR in the delivery room raises questions about whether using a specifically tailored CPR approach during neonatal CPR could improve outcomes.

This ongoing lack of high-quality evidence (i.e., large randomized clinical trials) to better guide healthcare providers in resuscitative effort, arises from (1) the relatively infrequent need to use CPR during neonatal resuscitation and (2) inability to consistently anticipate which newborn infants are at high risk of requiring extensive CPR. Guidelines for neonatal resuscitation recognize the lack of neonatal data and extrapolate data from studies with adults and children. These data may not fully apply to newborn infants.

This Special Issue of Healthcare seeks commentaries, original research, short reports, and reviews regarding the challenges in neonatal cardiopulmonary resuscitation. This Special Issue aims to present the current evidence, future approaches, and novel teaching techniques. It is envisioned that health care providers, researchers, health care policy specialists, policymakers, and elected officials will use this Special Issue as a resource for writing intelligent and progressive healthcare policies. 

Dr. Georg M. Schmölzer
Guest Editor

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• delivery room
• neonatal intensive care unit
• asphyxia
• chest compression
• vasopressors
• training and education
• neonatal resuscitation program
• pediatric advanced life support