Erstversorgung und Reanimation des Neugeborenen

M. Dzietko; P. Deindl; H. Sallmon; A. Stein; G. Hansmann

doi:10.1055/s-0037-1616346

Kinder- und Jugendmedizin, Table of Contents

Kinder- und Jugendmedizin 2016; 16(06): 433-438
DOI: 10.1055/s-0037-1616346

Neonatologie

Schattauer GmbH

Erstversorgung und Reanimation des Neugeborenen

Update 2016Resuscitation and initial management of the newbornUpdate 2016

M. Dzietko

¹Kinderklinik I, Klinik für Neonatologie und Pädiatrische Intensivmedizin, Universitätsklinikum Essen

,

P. Deindl

²Sektion Neonatologie und Pädiatrische Intensivmedizin, Universitätsklinikum Hamburg-Eppendorf

,

H. Sallmon

³Klinik für Neonatologie, Charité – Universitätsmedizin Berlin

,

A. Stein

¹Kinderklinik I, Klinik für Neonatologie und Pädiatrische Intensivmedizin, Universitätsklinikum Essen

,

G. Hansmann

⁴Klinik für Pädiatrische Kardiologie und Intensivmedizin, Medizinische Hochschule Hannover

› Author Affiliations

Abstract

Zusammenfassung

Hintergrund: Die Wiederbelebung des Neugeborenen ist ein seltenes Ereignis. Deswegen kann es gerade in solchen stressbeladenen Situationen zu Fehleinschätzungen der betreuenden Personen kommen.

Methode: Es erfolgte eine selektive Literaturrecherche in Pubmed und Medline unter Bezug auf nationale und internationale Leitlinien und systematische Übersichtsarbeiten.

Ergebnisse: Es werden der seit 2015 geltende Algorithmus für die kardiopulmonale Reanimation des Neugeborenen und die Veränderungen im Vergleich zu 2010 beschrieben. Darüber hinaus wird dargestellt, welchen Bedarf an Hilfe ein Neugeborenes nach der Geburt hat, welches Equipment zur Versorgung mindestens notwendig ist und wie die Wiederbelebung des Neugeborenen im Detail inklusive Gefäßzugängen und Medikamenten durchgeführt werden sollte.

Schlussfolgerungen: Reanimationen beim Neugeborenen treten sehr selten auf. Aus diesem Grunde sollten der Algorithmus nach aktuellsten Richtlinien wiederholt und praktisches Training in regelmäßigen Abständen durchgeführt werden.

Summary

Background: Resuscitation of the newborn is a rare event. Therefore, those stressful situations are prone for misjudgment of caretakers.

Methods: A selective literature search has been carried out in Pubmed and Medline for national and international guidelines and systematic reviews.

Results: The algorithm 2015 and changes for cardiopulmonary resuscitation of the newborn will be described in comparison to 2010. In addition, the special need of the newborn infant after birth, the minimal equipment necessary, and the resuscitation algorithm including vascular access and drugs are described in detail.

Conclusions: Resuscitation of the newborn is a rare event. Therefore, the algorithm following the latest guideline should be repeated and practiced in regular intervals.

Schlüsselwörter

Neugeborenes - Wiederbelebung - Temperatur - Sauerstoff - Mekonium

Keywords

Newborn - resuscitation - temperature - oxygen - meconium

Full Text

References

Literatur
1 Ersdal HL. et al. Early initiation of basic resuscitation interventions including face mask ventilation may reduce birth asphyxia related mortality in low-income countries: a prospective descriptive observational study. Resuscitation 2012; 83: 869-873.
2 Barber CA, Wyckoff MH. Use and efficacy of endotracheal versus intravenous epinephrine during neonatal cardiopulmonary resuscitation in the delivery room. Pediatrics 2006; 118: 1028-1034.
3 Aziz K. et al. Ante- and intra-partum factors that predict increased need for neonatal resuscitation. Resuscitation 2008; 79: 444-452.
4 Wyllie J. et al. European Resuscitation Council Guidelines for Resuscitation, Section 7. Resuscitation and support of transition of babies at birth. European Resuscitation Council, American Heart Association, Inc., and International Liaison Committee on Resuscitation. Resuscitation 2015; 95: 249-263.
5 Wyckoff MH. et al. Part 13: neonatal resuscitation: American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation 2015; 132: 543-560.
6 O’Donnell CP. et al. Clinical assessment of infant colour at delivery. Arch Dis Child Fetal Neonatal 2007; 92: 465-467.
7 Owen CJ, Wyllie JP. Determination of heart rate in the baby at birth. Resuscitation 2004; 60: 213-217.
8 Katheria A, Rich W, Finer N. Electrocardiogram provides a continuous heart rate faster than oximetry during neonatal resuscitation. Pediatrics 2012; 130: 1177-1181.
9 van Vonderen JJ. et al. Pulse oximetry measures a lower heart rate at birth compared with electrocardiography. J Pediatr 2015; 166: 49-53.
10 Boon AW, Milner AD, Hopkin IE. Lung expansion, tidal exchange, and formation of the functional residual capacity during resuscitation of asphyxiated neonates. J Pediatr 1979; 95: 1031-1036.
11 Hird MF, Greenough A, Gamsu HR. Inflating pressures for effective resuscitation of preterm infants. Early Hum Dev 1991; 26: 69-72.
12 Lindner W. et al. Delivery room management of extremely low birth weight infants. spontaneous breathing or intubation?. Pediatrics 1999; 103: 961-967.
13 Wood FE. et al. Assessing the effectiveness of two round neonatal resuscitation masks. Arch Dis Child Fetal Neonatal 2008; 93: 235-237.
14 Trevisanuto D. et al. Supreme laryngeal mask airway versus face mask during neonatal resuscitation: a randomized controlled trial. J Pediatr 2015; 167: 286-291.
15 Roehr CC. et al. Manual ventilation devices in neonatal resuscitation: tidal volume and positive pressure-provision. Resuscitation 2010; 81: 202-205.
16 Morley CJ. et al. Nasal CPAP or intubation at birth for very preterm infants. N Engl J Med 2008; 358: 700-708.
17 Network SUPPORT Study Group of the Eunice Kennedy Shriver NICHD Neonatal Research Network. Finer NN, Carlo WA. et al. Early CPAP versus surfactant in extremely preterm infants. N Engl J Med 2010; 362: 1970-1909.
18 Dunn MS. et al. Randomized trial comparing 3 approaches to the initial respiratory management of preterm neonates. Pediatrics 2011; 128: 1069-1076.
19 Chettri S, Adhisivam B, Bhat BV. Endotracheal suction for nonvigorous neonates born through meconium stained amniotic fluid: a randomized controlled trial. J Pediatr 2015; 166: 1208-1213.
20 Christman C. et al. The two-thumb is superior to the two-finger method for administering chest compressions in a manikin model of neonatal resuscitation. Arch Dis Child Fetal Neonatal Ed 2011; 96: 99-101.
21 Park J. et al. Manikin-integrated digital measuring system for assessment of infant cardiopulmonary resuscitation techniques. IEEE J Biomed Health Inform 2014; 18: 1659-1667.
22 Wyckoff MH, Perlman JM, Laptook AR. Use of volume expansion during delivery room resuscitation in near-term and term infants. Pediatrics 2005; 115: 950-955.
23 de Almeida MF. et al. Hypothermia and early neonatal mortality in preterm infants. J Pediatr 2014; 164: 271-275.
24 Garcia-Munoz Rodrigo F, Rivero Rodriguez S, Siles Quesada C. Hypothermia risk factors in the very low weight newborn and associated morbidity and mortality in a neonatal care unit. An Pediatr (Barc) 2014; 80: 144-150.
25 Reilly MC. et al. Randomized trial of occlusive wrap for heat loss prevention in preterm infants. J Pediatr 2015; 166: 262-268e2.
26 Wyllie J. et al. Part 11: Neonatal resuscitation: 2010 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science with Treatment Recommendations. Resuscitation 2010; 81: 260-287.
27 Ghavam S. et al. Effects of placental transfusion in extremely low birthweight infants: meta-analysis of long- and short-term outcomes. Transfusion 2014; 54: 1192-1198.