Considerations on the Use of Neonatal and Pediatric Resuscitation Guidelines for Hospitalized Neonates and Infants: On Behalf of the American Heart Association Emergency Cardiovascular Care Committee and the American Academy of Pediatrics

Author:

Sawyer Taylor1,McBride Mary E.2,Ades Anne3,Kapadia Vishal S.4,Leone Tina A.5,Lakshminrusimha Satyan6,Ali Norjahan4,Marshall Stephanie7,Schmölzer Georg M.8,Kadlec Kelly D.9,Pusic Martin V.10,Bigham Blair L.11,Bhanji Farhan12,Donoghue Aaron J.13,Raymond Tia14,Kamath-Rayne Beena D.15,de Caen Allan16

Affiliation:

1. aDivision of Neonatology, Department of Pediatrics, University of Washington School of Medicine, Seattle, Washington

2. bDivisions of Pediatric Cardiology and Pediatric Critical Care Medicine, Department of Pediatrics

3. cDivisions of Neonatology

4. dDivision of Neonatal-Perinatal Medicine, Department of Pediatrics, University Southwestern Medical Center, Dallas, Texas

5. eDivision of Neonatology, Department of Pediatrics, Columbia University, New York, New York

6. fDepartment of Pediatrics, UC Davis Children’s Hospital, Sacramento, California

7. gNeonatology, Department of Pediatrics, Northwestern University Ann and Robert H Lurie Children’s Hospital of Chicago, Chicago, Illinois

8. hDivisions of Neonatology

9. iDivision of Critical Care, Department of Pediatrics, University of Nebraska Medical Center, Omaha, Nebraska

10. jDivision of Emergency Medicine, Department of Pediatrics, Harvard Medical School, Boston, Massachusetts

11. kDivision of Critical Care, Department of Anesthesia, Stanford University, Palo Alto, California

12. lDivision of Pediatric Critical Care, Department of Pediatrics, McGill University, Montreal, Quebec, Canada

13. mPediatric Intensive Care, Department of Pediatrics, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania

14. nDepartment of Pediatrics, Pediatric Cardiac Intensive Care, Medical City Children’s Hospital, Dallas, Texas

15. oGlobal Child Health and Life Support, American Academy of Pediatrics, Itasca, Illinois

16. pPediatric Critical Care, Department of Pediatrics, University of Alberta, Edmonton, Canada

Abstract

Between 0.25% and 3% of admissions to the NICU, PICU, and PCICU receive cardiopulmonary resuscitation (CPR). Most CPR events occur in patients <1 year old. The incidence of CPR is 10 times higher in the NICU than at birth. Therefore, optimizing the approach to CPR in hospitalized neonates and infants is important. At birth, the resuscitation of newborns is performed according to neonatal resuscitation guidelines. In older infants and children, resuscitation is performed according to pediatric resuscitation guidelines. Neonatal and pediatric guidelines differ in several important ways. There are no published recommendations to guide the transition from neonatal to pediatric guidelines. Therefore, hospitalized neonates and infants can be resuscitated using neonatal guidelines, pediatric guidelines, or a hybrid approach. This report summarizes the current neonatal and pediatric resuscitation guidelines, considers how to apply them to hospitalized neonates and infants, and identifies knowledge gaps and future priorities. The lack of strong scientific data makes it impossible to provide definitive recommendations on when to transition from neonatal to pediatric resuscitation guidelines. Therefore, it is up to health care teams and institutions to decide if neonatal or pediatric guidelines are the best choice in a given location or situation, considering local circumstances, health care team preferences, and resource limitations.

Publisher

American Academy of Pediatrics (AAP)

Subject

Pediatrics, Perinatology and Child Health

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