_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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