Abstract
Background/Aims: We questioned whether extremely low birth weight (ELWB) infants who undergo cardiopulmonary resuscitation (CPR) at delivery room present poorer survival and short-term outcomes than those who do not.
Methods: Data from all inborn ELWB infants from 2000 through 2004 in a universitary hospital were analyzed. Infants with major birth defects, suspicion of genetic disease and those without proactive perinatal attitude were excluded. CPR was defined as administration of chest compressions and/or epinephrine at delivery room. Neonatal morbidity was compared between infants who underwent CPR and those who did not.
Results: 150 infants were included, with gestational ages between 23 and 27 weeks (mean 25.6 ± 1.2), and birth weights from 425 to 995 grams (745.2 ± 132). Delivery room CPR was givent to 32 infants (21.4%). No differences in perinatal characteristics were found except for significant lower pH and Apgar score, and higher SNAPPE score in infants who underwent CPR. Survival at discharge was similar (62.5 % vs 76.3% for those without CPR). Infants who received CPR needed more surfactant, higher oxygen inspired fraction and higher median airway pressure than infants who did not. During first week of life no differences were found between both groups in type and length of ventilatory support, haemodinamic instability, persistent duct or early onset sepsis. Air leaks and coagulopathy were more frequent in CPR-infants (p< 0.01). Head ultrasound was available for 96.6% infants. No statistical differences were found in any grade of intraventricular haemorrhage (IVH) (62.5% vs 52.5%), IVH III (31.2% vs 17.7%), periventricular hemorrhagic infarction (18.7% vs 11%), cystic periventricular leukomalacia (15.6% vs 11%), bronchopulmonary dysplasia (37.5% vs 39%), and necrotizing enterocolitis II-III (12.4% vs 16.9%).
Conclusion: This study does not support a poorer survival and significant increased morbidity during the neonatal period in ELWB infants who receive CPR.
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Torres, A., Garcia-Alix, A., Gonzalez, F. et al. 323 Impact of Cardiopulmonary Resuscitation in ELWB Infants. Survival and Short-Term Outcomes. Pediatr Res 58, 410 (2005). https://doi.org/10.1203/00006450-200508000-00352
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DOI: https://doi.org/10.1203/00006450-200508000-00352