The Changing Landscape in Supporting Preterm Infants at Birth.

Abstract:

:Noninvasive ventilation for preterm infants at birth has been recommended and universally adopted. The umbilical cord is often clamped immediately in order to provide the support the infant needs for stabilization. However, recent scientific data from experimental studies that involve animals in transition and human studies using physiological measurements at birth have increased awareness as to how little we know about how these interventions interact and integrate with the infant's changing physiology. It has become clear that in apneic infants the larynx is closed immediately after birth, which can completely negate the effect of noninvasive ventilation of the lung. For this reason, stimulating and supporting spontaneous breathing could enhance the success of noninvasive ventilation. Animal data also demonstrated that the large swings in blood pressure, blood flow, and oxygenation caused by immediate cord clamping can be avoided by postponing cord clamping until lung aeration has been established. In this review we will focus on these "game changers" that have the potential to completely change the approach used in stabilizing preterm infants at birth.

journal_name

Neonatology

journal_title

Neonatology

authors

Te Pas AB,Hooper SB,Dekker J

doi

10.1159/000497421

subject

Has Abstract

pub_date

2019-01-01 00:00:00

pages

392-397

issue

4

eissn

1661-7800

issn

1661-7819

pii

000497421

journal_volume

115

pub_type

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