Delivery room handling of the newborn.
Delivery room handling of the newborn.
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DOI：
10.1515/jpm-2019-0304
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发表时间：
2019-12-18
影响因子：
2.4
通讯作者：
Saugstad OD
中科院分区：
文献类型：
--
作者：
Marshall S;Lang AM;Perez M;Saugstad OD
对于新生儿，特别是那些出生时需要干预的婴儿，在出生后的第一分钟，即所谓的“黄金分钟”采取的行动可能对长期结果产生重要影响。产房处理，包括识别母婴风险因素和提供有效的复苏干预措施，以及有关产前类固醇给药和分娩方式的产前护理决定，都很重要，可能会影响结局。预测需要复苏的高危新生儿的危险因素可以缩短复苏时间并改善预后。在回顾了影响新生儿复苏的母婴危险因素后，我们总结了目前产房处理新生儿的建议。这包括使用延迟脐带夹紧和脐带挤乳的建议和理由、心率评估[包括在产房使用心电图（ECG）电极]、新生儿复苏中吸引的作用以及各种复苏模式的影响。应通过脉搏血氧仪监测氧合。氧气和表面活性剂对随后的肺部结果的影响，并提供适当的体温调节支持的建议进行了讨论。应强制定期教授产房处理。
For newly born babies, especially those in need of intervention at birth, actions taken during the first minute after birth, the so-called “Golden Minute”, can have important implications for long-term outcomes. Both delivery room handling, including identification of maternal and infant risk factors and provision of effective resuscitation interventions, and antenatal care decisions regarding antenatal steroid administration and mode of delivery, are important and can affect outcomes. Anticipating risk factors for neonates at high risk of requiring resuscitation can decrease time to resuscitation and improve the prognosis. Following a review of maternal and fetal risk factors affecting newborn resuscitation, we summarize the current recommendations for delivery room handling of the newborn. This includes recommendations and rationale for the use of delayed cord clamping and cord milking, heart rate assessment [including the use of electrocardiogram (ECG) electrodes in the delivery room], role of suctioning in newborn resuscitation, and the impact of various ventilatory modes. Oxygenation should be monitored by pulse oximetry. Effects of oxygen and surfactant on subsequent pulmonary outcomes, and recommendations for provisions of appropriate thermoregulatory support are discussed. Regular teaching of delivery room handling should be mandatory.