![]() ![]() ![]() In the resuscitation of an infant, initial oxygen concentration of 21 percent is recommended. If the infant's heart rate is less than 60 beats per minute after effective positive pressure ventilation, then chest compressions should be initiated with continued positive pressure ventilation (3:1 ratio of compressions to ventilation 90 compressions and 30 breaths per minute).Įxhaled carbon dioxide detectors can be used to confirm endotracheal tube placement in an infant. If the infant's heart rate is less than 100 beats per minute and/or the infant has apnea or gasping respiration, positive pressure ventilation via face mask should be initiated with 21 percent oxygen (room air) or blended oxygen using a self-inflating bag, flow-inflating bag, or T-piece device while monitoring the inflation pressure. Other recommendations include confirming endotracheal tube placement using an exhaled carbon dioxide detector using less than 100 percent oxygen and adequate thermal support to resuscitate preterm infants and using therapeutic hypothermia for infants born at 36 weeks' gestation or later with moderate to severe hypoxic-ischemic encephalopathy.Ī team or persons trained in neonatal resuscitation should be promptly available at all deliveries to provide complete resuscitation, including endotracheal intubation and administration of medications. The updated guidelines also provide indications for chest compressions and for the use of intravenous epinephrine, which is the preferred route of administration, and recommend not to use sodium bicarbonate or naloxone during resuscitation. Among the most important changes are to not intervene with endotracheal suctioning in vigorous infants born through meconium-stained amniotic fluid (although endotracheal suctioning may be appropriate in nonvigorous infants) to provide positive pressure ventilation with one of three devices when necessary to begin resuscitation of term infants using room air or blended oxygen and to have a pulse oximeter readily available in the delivery room. The Neonatal Resuscitation Program, which was initiated in 1987 to identify infants at risk of needing resuscitation and provide high-quality resuscitation, underwent major updates in 20. A team or persons trained in neonatal resuscitation should be promptly available to provide resuscitation. Ninety percent of infants transition safely, and it is up to the physician to assess risk factors, identify the nearly 10 percent of infants who need resuscitation, and respond appropriately. We conclude that meconium-stained amniotic fluid is a risk factor for microbial invasion of the amniotic cavity and preterm delivery in women with preterm labor and intact membranes.Appropriate resuscitation must be available for each of the more than 4 million infants born annually in the United States. Patients with meconium-stained amniotic fluid were also more likely to have failed tocolysis and delivered a preterm neonate more frequently than patients with clear fluid (83% vs 38% (258/677) p = 0.0001 odds ratio = 8.1 95% confidence interval = 2.9 to 24.4). ![]() The prevalence of positive amniotic fluid cultures was significantly higher in women with meconium-stained amniotic fluid than in women with clear fluid (33% vs 11% p = 0.001 odds ratio = 4.01 95% confidence interval = 1.6 to 9.4). Meconium-stained amniotic fluid was present in 4.2% (30/707) of patients with preterm labor. Amniocentesis was performed on 707 patients presenting with preterm labor and intact membranes. ![]() The purpose of this study was to determine whether meconium-stained amniotic fluid is a marker for microbial invasion of the amniotic cavity. ![]()
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