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Initial resuscitation at delivery and short term neonatal outcomes in very-low-birth-weight infants

Title
Initial resuscitation at delivery and short term neonatal outcomes in very-low-birth-weight infants
Authors
Cho S.J.Shin J.Namgung R.
Ewha Authors
조수진
SCOPUS Author ID
조수진scopus
Issue Date
2015
Journal Title
Journal of Korean Medical Science
ISSN
1011-8934JCR Link
Citation
vol. 30, pp. S45 - S51
Keywords
Apgar scoreCardiopulmonary resuscitationInfant, prematureInfant, very-low-birth-weight
Publisher
Korean Academy of Medical Science
Indexed
SCI; SCIE; SCOPUS; KCI WOS scopus
Abstract
Survival of very-low-birth-weight infants (VLBWI) depends on professional perinatal management that begins at delivery. Korean Neonatal Network data on neonatal resuscitation management and initial care of VLBWI of less than 33 weeks gestation born from January 2013 to June 2014 were reviewed to investigate the current practice of neonatal resuscitation in Korea. Antenatal data, perinatal data, and short-term morbidities were analyzed. Out of 2,132 neonates, 91.7% needed resuscitation at birth, chest compression was performed on only 104 infants (5.4%) and epinephrine was administered to 80 infants (4.1%). Infants who received cardiac compression and/or epinephrine administration at birth (DR-CPR) were significantly more acidotic (P < 0.001) and hypothermic (P < 0.001) than those who only needed positive pressure ventilation (PPV). On logistic regression, DR-CPR resulted in greater early mortality of less than 7 days (OR, 5.64; 95% CI 3.25-9.77) increased intraventricular hemorrhage = grade 3 (OR, 2.71; 95% CI 1.57-4.68), periventricular leukomalacia (OR, 2.94; 95% CI 1.72-5.01), and necrotizing enterocolitis (OR, 2.12; 95% CI 1.15-3.91) compared with those infants who needed only PPV. Meticulous and aggressive management of infants who needed DR-CPR at birth and quality improvement of the delivery room management will result in reduced morbidities and early death for the vulnerable VLBWI.
DOI
10.3346/jkms.2015.30.S1.S45
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의학전문대학원 > 의학과 > Journal papers
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