Published online April 1, 2005
PEDIATRICS Vol. 115 No. 4 April 2005, pp. 950-955 (doi:10.1542/10.1542/peds.2004-0913)
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow E-mail this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrowRequest Permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via CrossRef
Right arrow Citing Articles via Web of Science (8)
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Wyckoff, M. H.
Right arrow Articles by Laptook, A. R.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Wyckoff, M. H.
Right arrow Articles by Laptook, A. R.
Related Collections
Right arrow Premature & Newborn
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us   Add to Digg   Add to Facebook   Add to Reddit   Add to Technorati   Add to Twitter  
What's this?

Use of Volume Expansion During Delivery Room Resuscitation in Near-Term and Term Infants

Myra H. Wyckoff, MD, Jeffrey M. Perlman, MB and Abbot R. Laptook, MD

From the Division of Neonatology, Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, Texas

Objective. To characterize use of volume infusion (VI) for infants who are ≥34 weeks' gestational age and receive intensive cardiopulmonary resuscitation (CPR; defined as >1 minute of positive-pressure ventilation and chest compressions, with or without the administration of medications) in the delivery room and are admitted to the NICU.

Methods. A retrospective review of a resuscitation registry between January 1999 and June 2001 was conducted.

Results. Of 37 972 infants, 23 received CPR, including 13 with VI. Ten of 13 received VI for persistent bradycardia despite CPR, and only 3 of 13 received VI for suspicion of hypovolemia with poor perfusion. More VI versus no VI infants had Apgar scores ≤2 at 5 and 10 minutes. VI versus no VI infants had lower cord arterial pH, had higher arterial partial pressure of carbon dioxide, had larger base deficit, required longer CPR, and required more epinephrine. On admission to the NICU, VI versus no VI infants had lower blood pressure and larger base deficit over the first 2 hours but did not differ in arterial pH, arterial partial pressure of carbon dioxide, heart rate, mortality, or use of additional VI or buffer.

Conclusions. VI is rarely given for overt hypovolemia and more often for asphyxiated infants who are slow to respond to intensive CPR. Persistent postnatal hypotension in VI infants suggests that other factors, eg, myocardial dysfunction, may be important contributors to lack of response to CPR.

Key Words: newborn • volume infusion • asphyxia • cardiopulmonary resuscitation • hypotension • hypovolemia

Abbreviations: DR, delivery room • VI, volume infusion • GA, gestational age • CPR, cardiopulmonary resuscitation • BMV, bag mask ventilation • PCO2, arterial partial pressure of carbon dioxide • MAP, mean arterial blood pressure • HCT, hematocrit

Accepted Aug 30, 2004.


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Digg Digg   Add to Facebook Facebook   Add to Reddit Reddit   Add to Technorati Technorati   Add to Twitter Twitter    What's this?


This article has been cited by other articles:


Home page
 Arch. Dis. Child. Fetal Neonatal Ed.Home page
C. J Morley and P. G Davis
Advances in neonatal resuscitation: supporting transition
Arch. Dis. Child. Fetal Neonatal Ed., September 1, 2008; 93(5): F334 - F336.
[Full Text] [PDF]

Home page
 PediatricsHome page
C. A. Barber and M. H. Wyckoff
Use and Efficacy of Endotracheal Versus Intravenous Epinephrine During Neonatal Cardiopulmonary Resuscitation in the Delivery Room
Pediatrics, September 1, 2006; 118(3): 1028 - 1034.
[Abstract] [Full Text] [PDF]

Home page
 PediatricsHome page
W. J. Keenan
Neonatal Resuscitation: What Role for Volume Expansion?
Pediatrics, April 1, 2005; 115(4): 1072 - 1073.
[Full Text] [PDF]