Skip to main content

Advertising Disclaimer »

Main menu

  • Journals
    • Pediatrics
    • Hospital Pediatrics
    • Pediatrics in Review
    • NeoReviews
    • AAP Grand Rounds
    • AAP News
  • Authors
    • Submit Manuscript
    • Author Guidelines
  • Content
    • Current Issue
    • Complete Issue PDF
    • Archive
    • Topic/Program Collections
    • Blog
  • Multimedia
    • Teaching Slides
    • Pediatrics On Call Podcast
  • CME/MOC
    • CME Quizzes
    • MOC Claiming
  • Subscribe
  • Alerts
  • Careers
  • Other Publications
    • American Academy of Pediatrics

User menu

  • Log in
  • My Cart

Search

  • Advanced search
American Academy of Pediatrics

AAP Gateway

Advanced Search

AAP Logo

  • Log in
  • My Cart
  • Journals
    • Pediatrics
    • Hospital Pediatrics
    • Pediatrics in Review
    • NeoReviews
    • AAP Grand Rounds
    • AAP News
  • Authors
    • Submit Manuscript
    • Author Guidelines
  • Content
    • Current Issue
    • Complete Issue PDF
    • Archive
    • Topic/Program Collections
    • Blog
  • Multimedia
    • Teaching Slides
    • Pediatrics On Call Podcast
  • CME/MOC
    • CME Quizzes
    • MOC Claiming
  • Subscribe
  • Alerts
  • Careers
American Academy of Pediatrics
In Briefs

Neonatal Resuscitation

Lisa M. Hainstock and Gauri R. Raval
Pediatrics in Review March 2020, 41 (3) 155-158; DOI: https://doi.org/10.1542/pir.2018-0203
Lisa M. Hainstock
*Department of Pediatrics, University of Virginia School of Medicine, Charlottesville, VA
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Gauri R. Raval
*Department of Pediatrics, University of Virginia School of Medicine, Charlottesville, VA
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • Article
  • Figures & Data
  • Info & Metrics
  • Comments
Loading

This article requires a subscription to view the full text. If you have a subscription you may use the login form below to view the article. Access to this article can also be purchased.

Download PDF
  1. Lisa M. Hainstock, MD*
  2. Gauri R. Raval, MD, MPH*
  1. *Department of Pediatrics, University of Virginia School of Medicine, Charlottesville, VA
  • AUTHOR DISCLOSURE

    Drs Hainstock and Raval have disclosed no financial relationships relevant to this article. This commentary does not contain a discussion of an unapproved/investigative use of a commercial product/device.

Newborns go through a complex set of physiologic changes to successfully transition to extrauterine life. These changes quickly shift responsibility for gas exchange from the placenta to the newborn’s lungs. The infant’s initial breaths and respiratory effort are the catalyst; they drive up intrapulmonary pressures and help clear fetal lung fluid. Increased blood oxygen content decreases pulmonary vascular resistance, increases pulmonary blood flow, and facilitates closure of the foramen ovale and patent ductus arteriosus, which previously shunted blood away from fetal lung circulation. Just as a newborn’s efforts at ventilation are key to a successful transition after birth, the most important part of newborn resuscitation is effective ventilation.

In 2015, the Neonatal Resuscitation Program (NRP) published updated guidelines for neonatal resuscitation. Key additions to the 2015 NRP algorithm include consideration of using 3-lead electrocardiography (ECG) to monitor heart rate (HR) and initiating intubation before chest compressions. The guidelines now recommend that providers 1) do not routinely intubate for tracheal suctioning in the setting of meconium aspiration, 2) ensure thermoregulation of all newborn infants between 97.7°F and 99°F (36.5°C and 37.5°C), and 3) delay cord clamping for all vigorous newborns.

The updated NRP algorithm (Figure) begins with a basic risk assessment by the clinician, asking if the baby is term, is crying or breathing, and has good muscle tone. If the answer to all of these questions is yes, the baby should be placed skin to skin with the mother with continued observation. If the answer to any of the questions is no, providers should move the infant to a radiant warmer and warm, dry, and stimulate the infant. If needed, …

Individual Login

Log in
You will be redirected to aap.org to login or to create your account.

Institutional Login

via Institution

You may be able to gain access using your login credentials for your institution. Contact your librarian or administrator if you do not have a username and password.

Log in through your institution

If your organization uses OpenAthens, you can log in using your OpenAthens username and password. To check if your institution is supported, please see this list. Contact your library for more details.

Purchase access

You may purchase access to this article. This will require you to create an account if you don't already have one.

Offer Reprints

PreviousNext
Back to top

Advertising Disclaimer »

In this issue

Pediatrics in Review: 41 (3)
Pediatrics in Review
Vol. 41, Issue 3
1 Mar 2020
  • Table of Contents
  • Table of Contents (PDF)
  • About the Cover
  • Index by author
  • Complete Issue (PDF)
View this article with LENS
PreviousNext
Email Article

Thank you for your interest in spreading the word on American Academy of Pediatrics.

NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
Neonatal Resuscitation
(Your Name) has sent you a message from American Academy of Pediatrics
(Your Name) thought you would like to see the American Academy of Pediatrics web site.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
Request Permissions
Article Alerts
Log in
You will be redirected to aap.org to login or to create your account.
Or Sign In to Email Alerts with your Email Address
Citation Tools
Neonatal Resuscitation
Lisa M. Hainstock, Gauri R. Raval
Pediatrics in Review Mar 2020, 41 (3) 155-158; DOI: 10.1542/pir.2018-0203

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
Share
Neonatal Resuscitation
Lisa M. Hainstock, Gauri R. Raval
Pediatrics in Review Mar 2020, 41 (3) 155-158; DOI: 10.1542/pir.2018-0203
del.icio.us logo Digg logo Reddit logo Twitter logo CiteULike logo Facebook logo Google logo Mendeley logo
Print
Download PDF
Insight Alerts
  • Table of Contents

Jump to section

  • Article
    • Suggested Reading
  • Figures & Data
  • Info & Metrics
  • Comments

Related Articles

  • No related articles found.
  • PubMed
  • Google Scholar

Cited By...

  • No citing articles found.
  • Google Scholar

More in this TOC Section

  • Antibiotic Stewardship
  • Treatment of Peanut Allergy
  • Pediatric Brain Death
Show more In Briefs

Similar Articles

Subjects

  • Fetus/Newborn Infant
    • Fetus/Newborn Infant
  • Administration/Practice Management
    • Standard of Care
    • Administration/Practice Management
  • Journal Info
  • Editorial Board
  • ABP Content Specifications Map
  • Overview
  • Licensing Information
  • Authors
  • Author Guidelines
  • Submit My Manuscript
  • Librarians
  • Institutional Subscriptions
  • Usage Stats
  • Support
  • Contact Us
  • Subscribe
  • Resources
  • Media Kit
  • About
  • International Access
  • Terms of Use
  • Privacy Statement
  • FAQ
  • AAP.org
  • shopAAP
  • Follow American Academy of Pediatrics on Instagram
  • Visit American Academy of Pediatrics on Facebook
  • Follow American Academy of Pediatrics on Twitter
  • Follow American Academy of Pediatrics on Youtube
American Academy of Pediatrics

© 2021 American Academy of Pediatrics