Favourable neurological outcomes following delivery room cardiopulmonary resuscitation of infants ≤ 750 g at birth

Abstract

Objective: To study short- and long-term outcomes of infants ≤ 750 g birthweight who received cardiopulmonary resuscitation (CPR) in the delivery room. Methodology: A retrospective analysis of all inborn live births ≤ 750 g birthweight from 1990 to 1996. Cardiopulmonary resuscitation was defined as positive pressure ventilation via an endotracheal tube and chest compressions. Univariate analyses were conducted comparing patients according to the use of CPR or positive pressure ventilation alone. Results: Cardiopulmonary resuscitation was administered to 16 infants: four received chest compressions only and 12 also received adrenaline. Cardiopulmonary resuscitation recipients had significantly lower Apgar scores at both 1 and 5 min, and had delayed onset of spontaneous respiration (P < 0.01). Seven patients died, and eight of nine survivors were free of major neurodevelopmental abnormalities at follow up. All CPR recipients with a 5 min Apgar score of ≤ 5 and delayed onset of spontaneous respiration beyond 5 min had poor outcomes. Conclusion: Contrary to the majority of published evidence, delivery room CPR in our extremely small infants was not associated with a high risk of severe neurodevelopmental disability.