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Resusitasi Neonatus 2020 AAP
Resusitasi Neonatus 2020 AAP
Khalid Aziz, MBBS, MA, MEd(IT), Chair; Henry C. Lee, MD, Vice Chair; Marilyn B. Escobedo, MD
Amber V. Hoover, RN, MSN; Beena D. Kamath-Rayne, MD, MPH; Vishal S. Kapadia, MD, MSCS;
David J. Magid, MD, MPH; Susan Niermeyer, MD, MPH; Georg M. Schmölzer, MD, PhD; Edgardo
Szyld, MD, MSc Gary M. Weiner, MD; Myra H. Wyckoff, MD Nicole K. Yamada, MD, MS; Jeanette
Zaichkin, RN, MN, NNP-BC
DOI: 10.1542/peds.2020-038505E
Journal: Pediatrics
Article Type: Supplement Article
Citation: Aziz K, Lee HC, Escobedo MB, et al. Part 5: Neonatal Resuscitation 2020 American Heart
Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care.
Pediatrics. 2020; doi: 10.1542/peds.2020-038505E
Khalid Aziz, MBBS, MA, MEd(IT), Chair; Henry C. Lee, MD, Vice Chair; Marilyn B. Escobedo, MD Amber V.
Hoover, RN, MSN; Beena D. Kamath-Rayne, MD, MPH; Vishal S. Kapadia, MD, MSCS; David J. Magid, MD, MPH
Susan Niermeyer, MD, MPH; Georg M. Schmölzer, MD, PhD; Edgardo Szyld, MD, MSc; Gary M. Weiner, MD;
Myra H. Wyckoff, MD Nicole K. Yamada, MD, MS; Jeanette Zaichkin, RN, MN, NNP-BC
PREAMBLE
It is estimated that approximately 10% of newly born infants need help to begin
breathing at birth,1–3 and approximately 1% need intensive resuscitative measures
to restore cardiorespiratory function.4,5 The neonatal mortality rate in the United
States and Canada has fallen from almost 20 per 1000 live births6,7 in the 1960s to
the current rate of approximately 4 per 1000 live births. The inability of newly born
infants to establish and sustain adequate or spontaneous respiration contributes
significantly to these early deaths and to the burden of adverse neurodevelop-
mental outcome among survivors. Effective and timely resuscitation at birth could
therefore improve neonatal outcomes further.
Successful neonatal resuscitation efforts depend on critical actions that must occur in
rapid succession to maximize the chances of survival. The International Liaison Commit-
tee on Resuscitation (ILCOR) Formula for Survival emphasizes 3 essential components
for good resuscitation outcomes: guidelines based on sound resuscitation science,
Class of Recommendation and Level of 2020 ILCOR International Consensus on CPR and ECC
Evidence Science With Treatment Recommendations evidence
Each AHA writing group reviewed all relevant and cur- and recommendations21 to determine if current guide-
rent AHA guidelines for CPR and ECC18–20 and all relevant lines should be reaffirmed, revised, or retired, or if new
Downloaded from www.aappublications.org/news at Indonesia:AAP Sponsored on October 31, 2020
Table. Applying Class of Recommendation and Level of Evidence to Clinical Strategies, Interventions, Treatments, or Diagnostic Testing in Patient
Care (Updated May 2019)*
recommendations were needed. The writing groups then clarifies the rationale and key study data supporting the
drafted, reviewed, and approved recommendations, as- recommendations. When appropriate, flow diagrams or
signing to each a Level of Evidence (LOE; ie, quality) and additional tables are included. Hyperlinked references
Class of Recommendation (COR; ie, strength) (Table).11 are provided to facilitate quick access and review.
PPV may be initiated with air (21% oxygen) in term and ECC emergency cardiovascular care
REFERENCES
WITHHOLDING AND DISCONTINUING
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2. Laptook AR, Shankaran S, Ambalavanan N, Carlo WA, McDonald SA, Recommendations for Withholding and Discontinuing Resuscitation
Higgins RD, Das A; Hypothermia Subcommittee of the NICHD Neo- COR LOE Recommendations
natal Research Network. Outcome of term infants using apgar scores
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2009;124:1619–1626. doi: 10.1542/peds.2009-0934 discontinuation of life-sustaining treatment
1 C-EO
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1 C-LD cessation of resuscitation efforts should be
fant outcome with a 10 min Apgar of 0. Arch Dis Child Fetal Neonatal Ed.
discussed with the team and the family. A
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reasonable time frame for this change in
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7. Wyckoff MH, Salhab WA, Heyne RJ, Kendrick DE, Stoll BJ, Laptook AR; decision-making.1,2,4,5
National Institute of Child Health and Human Development Neona-
tal Research Network. Outcome of extremely low birth weight infants Synopsis
who received delivery room cardiopulmonary resuscitation. J Pediatr. Expert neonatal and bioethical committees have agreed
2012;160:239–244.e2. doi: 10.1016/j.jpeds.2011.07.041
8. Salhab WA, Wyckoff MH, Laptook AR, Perlman JM. Initial hypoglycemia that, in certain clinical conditions, it is reasonable not
and neonatal brain injury in term infants with severe fetal acidemia. Pedi- to initiate or to discontinue life-sustaining efforts while
atrics. 2004;114:361–366. doi: 10.1542/peds.114.2.361 continuing to provide supportive care for babies and
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families.1,2,4
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Disclosures
Appendix 1. Writing Group Disclosures
Marilyn B University of Oklahoma None None None None None None None
Escobedo Medical School
Pediatrics
Amber V. Hoover American Heart None None None None None None None
Association
Beena D. American Academy of None None None None None None None
Kamath-Rayne Pediatrics
Vishal S. UT Southwestern NIH, NICHD† None None None None None None
Kapadia Pediatrics
David J. Magid University of Colorado NIH†; NHLBI†; None None None None None American Heart
CMS†; AHA† Association (Senior
Science Editor)†
(Continued )
Nicole K. Stanford University AHRQ† None None None None None None
Yamada
Jeanette Self used None None None None None American None
Zaichkin Academy of
Pediatrics
Neonatal
Resuscitation
Program†
This table represents the relationships of writing group members that may be perceived as actual or reasonably perceived conflicts of interest as reported on
the Disclosure Questionnaire, which all members of the writing group are required to complete and submit. A relationship is considered to be “significant” if
(a) the person receives $10 000 or more during any 12-month period, or 5% or more of the person’s gross income; or (b) the person owns 5% or more of the
voting stock or share of the entity, or owns $10 000 or more of the fair market value of the entity. A relationship is considered to be “modest” if it is less than
“significant” under the preceding definition.
*Modest.
†Significant.
Christoph Bührer Charité University None None University of None None None None
Medical Center Tübingen*
(Germany)
Praveen SUNY Buffalo None None None None None None None
Chandrasekharan
Krithika Lingappan Baylor College of None None None None None None None
Medicine
Ju-Lee Oei Royal Hospital for None None None None None None None
Women (Australia)
Birju A. Shah The University of None None None None None None None
Oklahoma
This table represents the relationships of reviewers that may be perceived as actual or reasonably perceived conflicts of interest as reported on the Disclosure
Questionnaire, which all reviewers are required to complete and submit. A relationship is considered to be “significant” if (a) the person receives $10000 or more
during any 12-month period, or 5% or more of the person’s gross income; or (b) the person owns 5% or more of the voting stock or share of the entity, or owns
$10 000 or more of the fair market value of the entity. A relationship is considered to be “modest” if it is less than “significant” under the preceding definition.
*Modest.
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