ABSTRACT
After the publication of the recommendations, agreed by all the scientific societies through the ILCOR, at the end of 2020, the GRN-SENeo began a process of analysis and review of the main changes since the last guidelines, to which a specific consensus positioning on controversial issues, trying to avoid ambiguities and trying to adapt the evidence to our environment. This text summarizes the main conclusions of this work and reflects the positioning of that group.
Subject(s)
Resuscitation , ConsensusABSTRACT
Tras la publicación de las recomendaciones, consensuadas por todas las sociedades científicas a través del ILCOR, a finales del año 2020, el GRN-SENeo inició un proceso de análisis y revisión de los principales cambios desde las últimas guías, a los que se añadió un posicionamiento específico de consenso en temas controvertidos, tratando de evitar ambigüedades, y procurando adaptar la evidencia a nuestro medio. El presente texto, resume las principales conclusiones de este trabajo y refleja el posicionamiento de dicho grupo. (AU)
After the publication of the recommendations, agreed by all the scientific societies through the ILCOR, at the end of 2020, the GRN-SENeo began a process of analysis and review of the main changes since the last guidelines, to which a specific consensus positioning on controversial issues, trying to avoid ambiguities and trying to adapt the evidence to our environment. This text summarizes the main conclusions of this work and reflects the positioning of that group. (AU)
Subject(s)
Humans , Infant, Newborn , Child Health , Cardiopulmonary Resuscitation , Infant, Newborn , Consensus , NeonatologyABSTRACT
After the publication of the recommendations, agreed by all the scientific societies through the ILCOR, at the end of 2020, the GRN-SENeo began a process of analysis and review of the main changes since the last guidelines, to which a specific consensus positioning on controversial issues, trying to avoid ambiguities and trying to adapt the evidence to our environment. This text summarizes the main conclusions of this work and reflects the positioning of that group.
ABSTRACT
BACKGROUND: A complete course of prenatal corticosteroids reduces the possibility of morbimortality and neonatal respiratory distress syndrome (RDS). Occasionally, it is not possible to initiate or complete the maturation regimen, and the preterm neonate is born in a non-tertiary hospital. This study aimed to assess the effects of a single dose of betamethasone within 3 h before delivery on serious outcomes (mortality and serious sequelae) and RDS in preterm neonates born in tertiary vs. non-tertiary hospitals. MATERIALS AND METHODS: Preterm neonates who were <35 weeks and ≤1500 g, treated during a period of five years in a level IIIC NICU, were included in this retrospective cohort study. Participants were divided into groups as follows: NM, non-matured; PM, partial maturation (one dose of betamethasone up to 3 h antepartum). They were further divided based on their place of birth (NICU-IIIC vs. non-tertiary hospitals). The morbimortality rates and the severity of neonatal RDS were evaluated. RESULTS: A total of 76 preterm neonates were included. A decrease in serious outcomes was found in the PM group in comparison to the NM group (OR = 0.2; 95%CI (0.07-0.9)), as well as reduced need for mechanical ventilation (54% vs. 68%). The mean time between maternal admission and birth was similar in both cohorts. The mean time from the administration of betamethasone to delivery was 1 h in the PM cohort. With regard to births in NICU-IIIC, the PM group performed better in terms of serious outcomes (32% vs. 45%) and the duration of mechanical ventilation (117.75 vs. 132.18 h) compared to the NM group. In neonates born in non-tertiary hospitals with PM in comparison to the NM group, a trend towards a reduced serious outcome (28.5% vs. 62.2%) and a decreased need for mechanical ventilation (OR = 0.09; 95%CI (0.01-0.8)) and maximum FiO2 (p = 0.01) was observed. CONCLUSIONS: A single dose of betamethasone up to 3 h antepartum may reduce the rate of serious outcomes and the severity of neonatal RDS, especially in non-tertiary hospitals.
ABSTRACT
Las recomendaciones internacionales del International Liaison Committee on Resuscitation (ILCOR), mediante una revisión exhaustiva de la evidencia disponible en el desarrollo de las medidas de soporte a la transición y de reanimación del recién nacido tras su nacimiento, aportan una guía universal a partir de la cual cada grupo o comité local puede adaptarla a su realidad e idiosincrasia, y elaborar sus propias guías o recomendaciones. El objetivo de esta revisión es analizar los principales cambios, abordar las controversias generadas desde 2010, contrastarlas con las de otras organizaciones nacionales e internacionales como son la European Resuscitation Council (ERC), American Heart Association (AHA) o la Australian-New Zealand Committee on Resuscitation (ANZCOR). De esta forma, el Grupo de Reanimación Neonatal de la Sociedad Española de Neonatología (GRN-SENeo) consensúa respuestas claras sobre muchas de las preguntas que ofrecen diferentes opciones de actuación, y genera las próximas recomendaciones de nuestro país para el soporte a la transición o la reanimación del recién nacido tras su nacimiento, con seguridad y eficacia
The International Liaison Committee on Resuscitation (ILCOR) recommendations provide a universal guide of measures to support the transition and resuscitation of newborn after their birth. This guide is expected to be adapted by local groups or committees on resuscitation, according to their own circumstances. The objective of this review is to analyse the main changes, to discuss several of the controversies that have appeared since 2010, and contrasting with other national and international organisations, such as European Resuscitation Council (ERC), American Heart Association (AHA), or the Australian-New Zealand Committee on Resuscitation (ANZCOR). Thus, the Neonatal Resuscitation Group of the Spanish Society of Neonatology (GRN-SENeo) aims to give clear answers to many of the questions when different options are available, generating the forthcoming recommendations of our country to support the transition and/or resuscitation of a newborn after birth, safely and effectively
Subject(s)
Humans , Male , Female , Infant, Newborn , Algorithms , Amniotic Fluid/cytology , Heart Rate/physiology , Hypothermia, Induced/methods , Hypothermia, Induced/standards , International Cooperation/policies , Hospital Rapid Response Team , Transitional Care , Amniotic Fluid/physiology , Umbilical Cord/cytology , Umbilical Cord/physiology , Glucose/administration & dosage , International Cooperation/methods , Resuscitation/standardsABSTRACT
The International Liaison Committee on Resuscitation (ILCOR) recommendations provide a universal guide of measures to support the transition and resuscitation of newborn after their birth. This guide is expected to be adapted by local groups or committees on resuscitation, according to their own circumstances. The objective of this review is to analyse the main changes, to discuss several of the controversies that have appeared since 2010, and contrasting with other national and international organisations, such as European Resuscitation Council (ERC), American Heart Association (AHA), or the Australian-New Zealand Committee on Resuscitation (ANZCOR). Thus, the Neonatal Resuscitation Group of the Spanish Society of Neonatology (GRN-SENeo) aims to give clear answers to many of the questions when different options are available, generating the forthcoming recommendations of our country to support the transition and/or resuscitation of a newborn after birth, safely and effectively.
