Neonatal resuscitation in low-resource settings: what, who, and how to overcome challenges to scale up?
Neonatal resuscitation in low-resource settings: what, who, and how to overcome challenges to scale up?
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DOI：
10.1016/j.ijgo.2009.07.013
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发表时间：
2009-10
影响因子：
3.8
通讯作者：
Lawn, Joy E.
中科院分区：
文献类型：
--
作者：
Wall, Stephen N.;Lee, Anne C. C.;Niermeyer, Susan;English, Mike;Keenan, William J.;Carlo, Wally;Bhutta, Zulfiqar A.;Bang, Abhay;Narayanan, Indira;Ariawan, Iwan;Lawn, Joy E.
关键词：
每年约有1000万婴儿在出生时不能立即呼吸，其中约600万需要基本的新生儿复苏。主要负担是在低收入环境中，那里的卫生系统提供新生儿复苏的能力不足。为了系统地审查新生儿复苏内容，培训和能力，设备和用品，成本和关键计划的考虑因素，特别是资源有限的设置的证据。几项观察性研究的证据表明，基于设施的基本新生儿复苏可避免30%的产时相关新生儿死亡。很少有婴儿需要高级复苏（气管插管和药物），这些新生儿可能无法生存，没有持续的通气;因此，高级新生儿复苏不是没有新生儿重症监护的优先事项。在6000万非设施分娩中，大多数人无法获得复苏。几项试验表明，一系列社区卫生工作者可以进行新生儿复苏，根据专家意见，估计其效果是减少20%的产时相关新生儿死亡。案例研究说明了扩大规模的主要考虑因素。基本的复苏将大大减少产时相关的新生儿死亡。在设施内分娩的情况下，优先事项是确保所有助产人员都有能力进行复苏。迫切需要制定战略，解决在家分娩的差距。需要更多的数据来确定新生儿复苏的影响，特别是对低收入环境的长期结果。
Each year approximately 10 million babies do not breathe immediately at birth, of which about 6 million require basic neonatal resuscitation. The major burden is in low-income settings, where health system capacity to provide neonatal resuscitation is inadequate. To systematically review the evidence for neonatal resuscitation content, training and competency, equipment and supplies, cost, and key program considerations, specifically for resource-constrained settings. Evidence from several observational studies shows that facility-based basic neonatal resuscitation may avert 30% of intrapartum-related neonatal deaths. Very few babies require advanced resuscitation (endotracheal intubation and drugs) and these newborns may not survive without ongoing ventilation; hence, advanced neonatal resuscitation is not a priority in settings without neonatal intensive care. Of the 60 million nonfacility births, most do not have access to resuscitation. Several trials have shown that a range of community health workers can perform neonatal resuscitation with an estimated effect of a 20% reduction in intrapartum-related neonatal deaths, based on expert opinion. Case studies illustrate key considerations for scale up. Basic resuscitation would substantially reduce intrapartum-related neonatal deaths. Where births occur in facilities, it is a priority to ensure that all birth attendants are competent in resuscitation. Strategies to address the gap for home births are urgently required. More data are required to determine the impact of neonatal resuscitation, particularly on long-term outcomes in low-income settings.
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影响因子：
2.4
作者：
Azzopardi D;Brocklehurst P;Edwards D;Halliday H;Levene M;Thoresen M;Whitelaw A;TOBY Study Group
通讯作者：
TOBY Study Group
影响因子：
3.8
作者：
Darmstadt, Gary L.;Lee, Anne C. C.;Cousens, Simon;Sibley, Lynn;Bhutta, Zulfiqar A.;Donnay, France;Osrin, Dave;Bang, Abhay;Kumar, Vishwajeet;Wall, Steven N.;Baqui, Abdullah;Lawn, Joy E.
通讯作者：
Lawn, Joy E.
影响因子：
5.1
作者：
Carlo, Waldemar A.;Wright, Linda L.;Harris, Hillary
通讯作者：
Harris, Hillary
影响因子：
2
作者：
Ghosh, D;Bhakoo, ON;Dhall, K
通讯作者：
Dhall, K
影响因子：
6.2
作者：
BURCHFIELD, DJ;BERKOWITZ, ID;GOLDBERG, RN
通讯作者：
GOLDBERG, RN