Die Versorgung und Reanimation des Neugeborenen

Madar, John; Roehr, Charles C; Ainsworth, Sean; Ersdal, H.; Morley, Claire; Rüdiger, Mario; Skåre, Christiane; Szczapa, Tomasz; Pas, Arjan B. te; Trevisanuto, Daniele; Urlesberger, Berndt; Wilkinson, D.; Wyllie, Jonathan

doi:10.1007/s10049-020-00722-7

Cited by 4 publications

(2 citation statements)

References 13 publications

(13 reference statements)

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“…Considerable effort has been directed over recent years towards encouraging use of delayed cord clamping (DCC), rather than the decades-long practice of immediate/early cord clamping, after delivery at birth (McAdams, 2014;Rabe et al, 2022). As part of this effort, professional bodies such as the American College of Obstetrics and Gynaecology (American College of Obstetrics & Gynaecology, 2020), the European Resuscitation Council (Madar et al, 2021), the European Society for Paediatric Research (Sweet et al, 2019) and the International Liaison Council on Resuscitation (Wyckoff et al, 2022) have recommended that cord clamping be deferred for intervals ranging from 30 to ≥60 s after delivery in preterm or term births not requiring resuscitation. Consistent with these recommendations, the interval between delivery and DCC in the majority of published randomized controlled trials has ranged from 30 s to 2 min (Fogarty et al, 2018;Jasani et al, 2021;McDonald et al, 2013;Seidler et al, 2021).…”

Section: Introductionmentioning

confidence: 99%

Extended period of ventilation before delayed cord clamping augments left‐to‐right shunting and decreases systemic perfusion at birth in preterm lambs

Smolich,

Kenna,

Mynard

2024

The Journal of Physiology

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Previous studies have suggested that an extended period of ventilation before delayed cord clamping (DCC) augments birth‐related rises in pulmonary arterial (PA) blood flow. However, it is unknown whether this greater rise in PA flow is accompanied by increases in left ventricular (LV) output and systemic arterial perfusion or whether it reflects enhanced left‐to‐right shunting across the ductus arteriosus and/or foramen ovale (FO), with decreased systemic arterial perfusion. Using an established preterm lamb birth transition model, this study compared the effect of a short (∼40 s, n = 11), moderate (∼2 min, n = 11) or extended (∼5 min, n = 12) period of initial mechanical lung ventilation before DCC on flow probe‐derived perinatal changes in PA flow, LV output, total systemic arterial blood flow, ductal shunting and FO shunting. The LV output was relatively stable during initial ventilation but increased after DCC, with similar responses in all groups. Systemic arterial flow patterns displayed only minor differences during brief and moderate periods of initial ventilation and were similar after DCC. However, an increase in PA flow was augmented with an extended initial ventilation (P < 0.001), owing to an earlier onset of left‐to‐right ductal and FO shunting (P < 0.001), and was accompanied by a pronounced reduction in total systemic arterial flow (P = 0.005) that persisted for 4 min after DCC (P ≤ 0.039). These findings suggest that, owing to increased left‐to‐right shunting and a greater reduction in systemic arterial perfusion, an extended period of ventilation before DCC does not result in greater perinatal circulatory benefits than shorter periods of initial ventilation in the birth transition. imageKey points Previous studies suggest that an extended period of initial ventilation before delayed cord clamping (DCC) augments birth‐related rises in pulmonary arterial (PA) blood flow. It is unknown whether this greater rise in PA flow is accompanied by an increased left ventricular output and systemic arterial perfusion or whether it reflects enhanced left‐to‐right shunting across the ductus arteriosus and/or foramen ovale, with decreased systemic arterial perfusion. Anaesthetized preterm fetal lambs instrumented with central arterial flow probes underwent a brief (∼40 s), moderate (∼2 min) or extended (∼5 min) period of ventilation before DCC. Perinatal changes in left ventricular output were similar in all groups, but extended initial ventilation augmented both perinatal increases in PA flow, owing to earlier onset and greater left‐to‐right ductal and foramen ovale shunting, and perinatal reductions in total systemic arterial perfusion. Extended ventilation before DCC does not confer a greater perinatal circulatory benefit than shorter periods of initial ventilation.

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Section: Introductionmentioning

confidence: 99%

Extended period of ventilation before delayed cord clamping augments left‐to‐right shunting and decreases systemic perfusion at birth in preterm lambs

Smolich,

Kenna,

Mynard

2024

The Journal of Physiology

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“…Liebe Leserinnen, liebe Leser, heute sind wir in der glücklichen Lage, Ihnen wieder eines der wichtigen und alle fünf Jahre erscheinenden Updates der Reanimationsleitlinien anzukündigen und auch bereits in der deutschen Übersetzung vorzustellen. Dabei ist es gerade einmal ein knappes Jahr her, da mussten European Resuscitation Council (ERC) und German Resuscitation Council -Deut-scherRat fürWiederbelebung(GRC)ihre Leitlinien zur Reanimation von Erwachsenen und Kindern an die COVID-19-Pandemie anpassen [1][2][3][4][5]. Es war damals abzuwägen zwischen den Notwendigkeiten des Selbstschutzes der Helfer*innen und dem optimalen Nutzen für die betroffenen Patient*innen.…”

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Die neuen internationalen Leitlinien zur Reanimation 2021 – sie sind da!

Dirks

Böttiger

2021

Notfall Rettungsmed

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Die neuen internationalenLeitlinien zur Reanimation 2021sie sind da! Liebe Leserinnen, liebe Leser, heute sind wir in der glücklichen Lage, Ihnen wieder eines der wichtigen und alle fünf Jahre erscheinenden Updates der Reanimationsleitlinien anzukündigen und auch bereits in der deutschen Übersetzung vorzustellen. Dabei ist es gerade einmal ein knappes Jahr her, da mussten European Resuscitation Council (ERC) und German Resuscitation Council -Deut-scherRat fürWiederbelebung(GRC)ihre Leitlinien zur Reanimation von Erwachsenen und Kindern an die COVID-19-Pandemie anpassen [1][2][3][4][5]. Es war damals abzuwägen zwischen den Notwendigkeiten des Selbstschutzes der Helfer*innen und dem optimalen Nutzen für die betroffenen Patient*innen.

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