_Resuscitation._ (javascript:AL_get(this, 'jour', 'Resuscitation.');)  2011 
Jan;82(1):40-4. Epub 2010 Oct 15. 
Is gastric aspiration needed for newborn management  in delivery room?
_Kiremitci S_ (/pubmed?term="Kiremitci%20S"[Author]) , _Tuzun F_ 
(/pubmed?term="Tuzun%20F"[Author]) , _Yesilirmak DC_ 
(/pubmed?term="Yesilirmak%20DC"[Author]) , _Kumral A_ (/pubmed?term="Kumral%20A"[Author]) , _Duman N_ 
(/pubmed?term="Duman%20N"[Author]) , _Ozkan H_ (/pubmed?term="Ozkan%20H"[Author]) . 
Dokuz Eylul University, Faculty of Medicine, Department of  Pediatrics, 
School of Medicine, Inciralti 35340, Izmir, Turkey. 
 
Abstract
AIM: Gastric aspiration is still  applied in many centres during delivery 
room management of the newborn without  any supporting evidence. We aimed to 
determine whether gastric aspiration  affects vital signs, oxygenation, 
nutrition and short-term prognosis of the  newborn. 
METHOD: A total of 310 eligible  healthy term newborns, identified from a 
total of 1300 live births, were  randomly allocated to receive either gastric 
aspiration or standard care. During  the first 20min, SpO(2), heart rate, 
cyanosis and retraction scores were  recorded once in a min; and blood 
pressure, respiration rate and neuroadaptive  capacity were recorded once in every 
5min. Information about nutrition and  vomiting behaviours of the babies 
were taken from the mothers of the neonates on  the postnatal 1st day at 
bedside and by a telephone call on the 7th  day. 
RESULTS: No difference was  determined between the groups in terms of 1st 
to 5thmin Apgar scores, attainment  duration of SpO(2) to 85%, 92% and 95%, 
mean heart rate and respiration rate.  Retraction frequency and mean systolic 
blood pressure of the 5th-min values were  found to be significantly higher 
in the gastric aspiration group. There was no  difference between the 
groups regarding breastfeeding starting time and vomiting  frequency. 
CONCLUSION: No positive effect of  gastric aspiration in delivery room m
anagement of the newborn was observed.  Conversely, the negative effects of 
gastric aspiration in neonates were observed  with respect to physiological 
parameters. Our data suggest that gastric  aspiration is not useful and may 
even be harmful in delivery room management of  the healthy term 
newborns.Copyright © 2010 Elsevier Ireland Ltd. All  rights reserved.
PMID: 20951491 [PubMed - in process] 
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_Best  Pract Res Clin Anaesthesiol._ 
(javascript:AL_get(this,%20'jour',%20'Best%20Pract%20Res%20Clin%20Anaesthesiol.');)  2010 Sep;24(3):461-74. 
Neonatal  resuscitation.
_Clifford M_ 
(http://www.ncbi.nlm.nih.gov/pubmed?term="Clifford%20M"[Author]) , _Hunt RW_ (http://www.ncbi.nlm.nih.gov/pubmed?term="Hunt%20RW"[Author]) 
. 
Department of  Anaesthesia and Pain Management, Paediatric Intensive Care 
Unit, The Royal  Children's Hospital, Melbourne, Australia.  
[log in to unmask] 
Abstract

Neonatal resuscitation  techniques are evolving. More sophisticated methods 
of monitoring have emerged  and current practices have been challenged. It 
is recognised that most newborns  will require only gentle assistance to 
facilitate the transition from  intrauterine life. The routine use of suction 
and oxygen supplementation is no  longer recommended and the effectiveness of 
current methods of delivering  ventilatory support has been questioned. The 
importance of effective use of  masks and optimising tidal ventilation 
rather than pressure generation is  emphasised. Newer oximetry technologies and 
the routine use of capnography may  facilitate clinical assessment even 
during active resuscitation. Methods of  warming infants have become 
increasingly effective and the use of servo-control  is emphasised to prevent 
overheating. Evidence to support therapeutic  hypothermia for the birth-asphyxiated 
baby is solid and cooling should be  considered a standard of care. The next 
revision of the International Liason  Committee on Resuscitation (ILCOR) 
Guidelines is eagerly awaited in  2010. 
PMID: 21033020 [PubMed  - indexed for MEDLINE] 
Nancy
Nancy E. Wight MD, IBCLC, FABM,  FAAP
Neonatologist
Sharp Mary Birch Hospital for Women and  Newborns
Medical Director, Sharp HealthCare Lactation Services
San Diego,  CA 
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