Preterm resuscitation I: Clinical approaches to improve management in delivery room

• Published in: Early human development Vol. 87; no. 11; pp. 749 - 753
• Main Authors: Rüdiger, Mario, Braun, Nicole, Gurth, Heidrun, Bergert, Renate, Dinger, Jürgen
• Format: Journal Article Conference Proceeding
• Language: English
• Published: Amsterdam Elsevier Ireland Ltd 01-11-2011; Elsevier
• Subjects: Advanced Basic Science; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Apgar Score; Biological and medical sciences; Delivery Rooms; Emergency and intensive care: neonates and children. Prematurity. Sudden death; Humans; Infant, Newborn; Infant, Premature; Intensive care medicine; Medical sciences; Neonatal and Perinatal Medicine; Observation; Patient Care Management - methods; Patient Care Management - organization & administration; Quality of Health Care - standards; Resuscitation; Human; Premature; Newborn; Prematurity; Neonatology; Hospitalization; Delivery; Video recording; Monitoring; Resuscitation
• ISSN: 0378-3782; 1872-6232
• DOI: 10.1016/j.earlhumdev.2011.08.019

Abstract Delivery room (DR-) management has a great potential to optimise quality of long term outcome in extremely preterm infants. However, a new conceptual framework that focuses on an individualised ‘support of transition’ rather than on ‘resuscitation’ is necessary. Video-recordings of DR-management represent a valuable tool to improve care. Recording combined with a structured feed-back should be introduced in step-wise approach in clinical routine. To describe the postnatal condition of groups of infants or to compare interventions in a research setting, a numerical score – representing the sum of several objective findings – is required. The conventional Apgar-Score has severe limitations that restrict its applicability. The Specified-Apgar allows an assessment of infant's condition independent of interventions and regardless of gestational age. The Expanded-Apgar quantifies the interventions needed to achieve the condition described by the Specified-Apgar. In summary, beside a new conceptual framework an individualised monitoring and an objective assessment of DR-management are required.