Interpretation of the updates in the pediatric and neonatal life support in <i>2022 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science with Treatment Recommendations</i>_West China Medical Journal

Authors：

LI Yuyao ^1,2,3 , YUAN Hongxiu ^1,3,4 ,  WANG Xiaodong ^1,2,3 ,  LI Xihong ^1,3,4

1. West China School of Medicine, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
2. Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
3. Key Laboratory of Birth Defects and Related Diseases of Women and Children (Ministry of Education), Sichuan University, Chengdu, Sichuan 610041, P. R. China;
4. Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding author：

WANG Xiaodong, Email: wangxd_scu@sina.com; LI Xihong, Email: hilixihong@163.com

Keywords：

Cardiopulmonary resuscitation; international consensus; life support; children; newborn

DOI：

10.7507/1002-0179.202212068

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

In November 2022, the International Liaison Committee on Resuscitation updated the International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science with Treatment Recommendations for the sixth time. The 2022 review includes 21 topics addressed with systematic reviews by the Recovery Task Force of International Liaison Committee on Resuscitation. Among them, there are nine topics related to life support for newborns and children, including public-access defibrillation devices for children, pediatric early warning systems, maintaining normal temperature immediately after birth, suctioning of amniotic fluid at birth, tactile stimulation for resuscitation immediately after birth, use of continuous positive airway pressure for respiratory distress at term birth, respiratory monitoring in the delivery room, heart rate monitoring in the delivery room, and supraglottic airway use in neonates. The Task Force made treatment recommendations for each of the above topics after weighing evidence and discussion. In some cases, good practice statements have been provided for topics thought to be of particular interest to the resuscitation community when the evidence is insufficient to support a recommendation. Good practice statements are not recommendations but represent expert opinion. In order to facilitate the readers to understand the treatment recommendation well, in the recommendation basis part, the basic principle is briefly described. In addition, the existing problems and future research directions of each topic after the systematic reviews are also clearly stated.

Citation： LI Yuyao, YUAN Hongxiu, WANG Xiaodong, LI Xihong. Interpretation of the updates in the pediatric and neonatal life support in 2022 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science with Treatment Recommendations. West China Medical Journal, 2023, 38(11): 1640-1647. doi: 10.7507/1002-0179.202212068 Copy

1.	Wyckoff MH, Greif R, Morley PT, et al. 2022 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations: summary from the Basic Life Support; Advanced Life Support; Pediatric Life Support; Neonatal Life Support; Education, Implementation, and Teams; and First Aid Task Forces. Circulation, 2022, 146(25): e483-e557.
2.	Naim MY, Burke RV, McNally BF, et al. Association of Bystander Cardiopulmonary Resuscitation With Overall and Neurologically Favorable Survival After Pediatric Out-of-Hospital Cardiac Arrest in the United States: a report from the Cardiac Arrest Registry to Enhance Survival Surveillance Registry. JAMA Pediatr, 2017, 171(2): 133-141.
3.	Naim MY, Griffis HM, Burke RV, et al. Race/ethnicity and neighborhood characteristics are associated with bystander cardiopulmonary resuscitation in pediatric out-of-hospital cardiac arrest in the united states: a study from CARES. J Am Heart Assoc, 2019, 8(14): e012637.
4.	Griffis H, Wu L, Naim MY, et al. Characteristics and outcomes of AED use in pediatric cardiac arrest in public settings: the influence of neighborhood characteristics. Resuscitation, 2020, 146: 126-131.
5.	Kiyohara K, Nitta M, Sato Y, et al. Ten-year trends of public-access defibrillation in Japanese school-aged patients having neurologically favorable survival after out-of-hospital cardiac arrest. Am J Cardiol, 2018, 122(5): 890-897.
6.	Maconochie IK, Aickin R, Hazinski MF, et al. Pediatric life support: 2020 international consensus on cardiopulmonary resuscitation and emergency cardiovascular care science with treatment recommendations. Circulation, 2020, 142(16 Suppl_1): S140-S184.
7.	Parshuram CS, Dryden-Palmer K, Farrell C, et al. Effect of a pediatric early warning system on all-cause mortality in hospitalized pediatric patients: the EPOCH randomized clinical trial. JAMA, 2018, 319(10): 1002-1012.
8.	Agulnik A, Mora Robles LN, Forbes PW, et al. Improved outcomes after successful implementation of a pediatric early warning system (PEWS) in a resource-limited pediatric oncology hospital. Cancer, 2017, 123(15): 2965-2974.
9.	Bonafide CP, Localio AR, Roberts KE, et al. Impact of rapid response system implementation on critical deterioration events in children. JAMA Pediatr, 2014, 168(1): 25-33.
10.	Perlman JM, Wyllie J, Kattwinkel J, et al. Part 7: neonatal resuscitation: 2015 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science with Treatment Recommendations. Circulation, 2015, 132(16 Suppl 1): S204-S241.
11.	Lunze K, Bloom DE, Jamison DT, et al. The global burden of neonatal hypothermia: systematic review of a major challenge for newborn survival. BMC Med, 2013, 11: 24.
12.	Agrawal N, Das K, Patwal P, et al. Wrapping newborn infants in cloth and newspaper after delivery led to higher temperatures on arrival at the neonatal intensive care unit. Acta Paediatr, 2018, 107(8): 1335-1338.
13.	Crenshaw JT, Adams ED, Gilder RE, et al. Effects of skin-to-skin care during cesareans: a quasiexperimental feasibility/pilot study. Breastfeed Med, 2019, 14(10): 731-743.
14.	Huang X, Chen L, Zhang L. Effects of paternal skin-to-skin contact in newborns and fathers after cesarean delivery. J Perinat Neonatal Nurs, 2019, 33(1): 68-73.
15.	Ramani M, Choe EA, Major M, et al. Kangaroo mother care for the prevention of neonatal hypothermia: a randomised controlled trial in term neonates. Arch Dis Child, 2018, 103(5): 492-497.
16.	Safari K, Saeed AA, Hasan SS, et al. The effect of mother and newborn early skin-to-skin contact on initiation of breastfeeding, newborn temperature and duration of third stage of labor. Int Breastfeed J, 2018, 13: 32.
17.	Wyckoff MH, Wyllie J, Aziz K, et al. Neonatal life support: 2020 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science with Treatment Recommendations. Circulation, 2020, 142(16_Suppl_1): S185-S221.
18.	Perlman JM, Wyllie J, Kattwinkel J, et al. Part 11: neonatal resuscitation: 2010 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science with Treatment Recommendations. Circulation, 2010, 122(16 Suppl 2): S516-S538.
19.	Bancalari A, Díaz V, Araneda H. Effects of pharyngeal suction on the arterial oxygen saturation and heart rate in healthy newborns delivered by elective cesarean section. J Neonatal Perinatal Med, 2019, 12(3): 271-276.
20.	Kelleher J, Bhat R, Salas AA, et al. Oronasopharyngeal suction versus wiping of the mouth and nose at birth: a randomised equivalency trial. Lancet, 2013, 382(9889): 326-330.
21.	Pocivalnik M, Urlesberger B, Ziehenberger E, et al. Oropharyngeal suctioning in neonates immediately after delivery: influence on cerebral and peripheral tissue oxygenation. Early Hum Dev, 2015, 91(2): 153-157.
22.	International Liaison Committee on Resuscitation. 2005 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science with Treatment Recommendations. Part 7: neonatal resuscitation. Resuscitation, 2005, 67(2/3): 293-303.
23.	Kattwinkel J, Niermeyer S, Nadkarni V, et al. ILCOR advisory statement: resuscitation of the newly born infant. An advisory statement from the pediatric working group of the International Liaison Committee on Resuscitation. Circulation, 1999, 99(14): 1927-1938.
24.	Guinsburg R, de Almeida MFB, Finan E, et al. Tactile stimulation in newborn infants with inadequate respiration at birth: a systematic review. Pediatrics, 2022, 149(4): e2021055067.
25.	Baik-Schneditz N, Urlesberger B, Schwaberger B, et al. Tactile stimulation during neonatal transition and its effect on vital parameters in neonates during neonatal transition. Acta Paediatr, 2018, 107(6): 952-957.
26.	Dekker J, Hooper SB, Martherus T, et al. Repetitive versus standard tactile stimulation of preterm infants at birth: a randomized controlled trial. Resuscitation, 2018, 127: 37-43.
27.	Pietravalle A, Cavallin F, Opocher A, et al. Neonatal tactile stimulation at birth in a low-resource setting. BMC Pediatr, 2018, 18(1): 306.
28.	Cavallin F, Lochoro P, Ictho J, et al. Corrigendum to “Back rubs or foot flicks for neonatal stimulation at birth in a low-resource setting: a randomized controlled trial” [Resuscitation 167 (2021) 137-143]. Resuscitation, 2021, 169: 314.
29.	Kc A, Peven K, Ameen S, et al. Neonatal resuscitation: EN-BIRTH multi-country validation study. BMC Pregnancy Childbirth, 2021, 21(Suppl 1): 235.
30.	Abbey NV, Mashruwala V, Weydig HM, et al. Electrocardiogram for heart rate evaluation during preterm resuscitation at birth: a randomized trial. Pediatr Res, 2022, 91(6): 1445-1451.
31.	Katheria A, Arnell K, Brown M, et al. A pilot randomized controlled trial of EKG for neonatal resuscitation. PLoS One, 2017, 12(11): e0187730.
32.	Shah BA, Wlodaver AG, Escobedo MB, et al. Impact of electronic cardiac (ECG) monitoring on delivery room resuscitation and neonatal outcomes. Resuscitation, 2019, 143: 10-16.
33.	Celebi MY, Alan S, Kahvecioglu D, et al. Impact of prophylactic continuous positive airway pressure on transient tachypnea of the newborn and neonatal intensive care admission in newborns delivered by elective cesarean section. Am J Perinatol, 2016, 33(1): 99-106.
34.	Osman AM, El-Farrash RA, Mohammed EH. Early rescue Neopuff for infants with transient tachypnea of newborn: a randomized controlled trial. J Matern Fetal Neonatal Med, 2019, 32(4): 597-603.
35.	Hishikawa K, Goishi K, Fujiwara T, et al. Pulmonary air leak associated with CPAP at term birth resuscitation. Arch Dis Child Fetal Neonatal Ed, 2015, 100(5): F382-387.
36.	Smithhart W, Wyckoff MH, Kapadia V, et al. Delivery room continuous positive airway pressure and pneumothorax. Pediatrics, 2019, 144(3): e20190756.
37.	Pejovic NJ, Myrnerts Höök S, Byamugisha J, et al. A randomized trial of laryngeal mask airway in neonatal resuscitation. N Engl J Med, 2020, 383(22): 2138-2147.
38.	Pejovic NJ, Trevisanuto D, Lubulwa C, et al. Neonatal resuscitation using a laryngeal mask airway: a randomised trial in Uganda. Arch Dis Child, 2018, 103(3): 255-260.
39.	Trevisanuto D, Cavallin F, Nguyen LN, et al. Supreme laryngeal mask airway versus face mask during neonatal resuscitation: a randomized controlled trial. J Pediatr, 2015, 167(2): 286-291.
40.	Pejovic NJ, Cavallin F, Mpamize A, et al. Respiratory monitoring during neonatal resuscitation using a supraglottic airway device vs. a face mask. Resuscitation, 2022, 171: 107-113.
41.	Schmölzer GM, Morley CJ, Wong C, et al. Respiratory function monitor guidance of mask ventilation in the delivery room: a feasibility study. J Pediatr, 2012, 160(3): 377-381.
42.	van Zanten HA, Kuypers KLAM, van Zwet EW, et al. A multi-centre randomised controlled trial of respiratory function monitoring during stabilisation of very preterm infants at birth. Resuscitation, 2021, 167: 317-325.
43.	Zeballos Sarrato G, Sánchez Luna M, Zeballos Sarrato S, et al. New strategies of pulmonary protection of preterm infants in the delivery room with the respiratory function monitoring. Am J Perinatol, 2019, 36(13): 1368-1376.

1. Wyckoff MH, Greif R, Morley PT, et al. 2022 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations: summary from the Basic Life Support; Advanced Life Support; Pediatric Life Support; Neonatal Life Support; Education, Implementation, and Teams; and First Aid Task Forces. Circulation, 2022, 146(25): e483-e557.
2. Naim MY, Burke RV, McNally BF, et al. Association of Bystander Cardiopulmonary Resuscitation With Overall and Neurologically Favorable Survival After Pediatric Out-of-Hospital Cardiac Arrest in the United States: a report from the Cardiac Arrest Registry to Enhance Survival Surveillance Registry. JAMA Pediatr, 2017, 171(2): 133-141.
3. Naim MY, Griffis HM, Burke RV, et al. Race/ethnicity and neighborhood characteristics are associated with bystander cardiopulmonary resuscitation in pediatric out-of-hospital cardiac arrest in the united states: a study from CARES. J Am Heart Assoc, 2019, 8(14): e012637.
4. Griffis H, Wu L, Naim MY, et al. Characteristics and outcomes of AED use in pediatric cardiac arrest in public settings: the influence of neighborhood characteristics. Resuscitation, 2020, 146: 126-131.
5. Kiyohara K, Nitta M, Sato Y, et al. Ten-year trends of public-access defibrillation in Japanese school-aged patients having neurologically favorable survival after out-of-hospital cardiac arrest. Am J Cardiol, 2018, 122(5): 890-897.
6. Maconochie IK, Aickin R, Hazinski MF, et al. Pediatric life support: 2020 international consensus on cardiopulmonary resuscitation and emergency cardiovascular care science with treatment recommendations. Circulation, 2020, 142(16 Suppl_1): S140-S184.
7. Parshuram CS, Dryden-Palmer K, Farrell C, et al. Effect of a pediatric early warning system on all-cause mortality in hospitalized pediatric patients: the EPOCH randomized clinical trial. JAMA, 2018, 319(10): 1002-1012.
8. Agulnik A, Mora Robles LN, Forbes PW, et al. Improved outcomes after successful implementation of a pediatric early warning system (PEWS) in a resource-limited pediatric oncology hospital. Cancer, 2017, 123(15): 2965-2974.
9. Bonafide CP, Localio AR, Roberts KE, et al. Impact of rapid response system implementation on critical deterioration events in children. JAMA Pediatr, 2014, 168(1): 25-33.
10. Perlman JM, Wyllie J, Kattwinkel J, et al. Part 7: neonatal resuscitation: 2015 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science with Treatment Recommendations. Circulation, 2015, 132(16 Suppl 1): S204-S241.
11. Lunze K, Bloom DE, Jamison DT, et al. The global burden of neonatal hypothermia: systematic review of a major challenge for newborn survival. BMC Med, 2013, 11: 24.
12. Agrawal N, Das K, Patwal P, et al. Wrapping newborn infants in cloth and newspaper after delivery led to higher temperatures on arrival at the neonatal intensive care unit. Acta Paediatr, 2018, 107(8): 1335-1338.
13. Crenshaw JT, Adams ED, Gilder RE, et al. Effects of skin-to-skin care during cesareans: a quasiexperimental feasibility/pilot study. Breastfeed Med, 2019, 14(10): 731-743.
14. Huang X, Chen L, Zhang L. Effects of paternal skin-to-skin contact in newborns and fathers after cesarean delivery. J Perinat Neonatal Nurs, 2019, 33(1): 68-73.
15. Ramani M, Choe EA, Major M, et al. Kangaroo mother care for the prevention of neonatal hypothermia: a randomised controlled trial in term neonates. Arch Dis Child, 2018, 103(5): 492-497.
16. Safari K, Saeed AA, Hasan SS, et al. The effect of mother and newborn early skin-to-skin contact on initiation of breastfeeding, newborn temperature and duration of third stage of labor. Int Breastfeed J, 2018, 13: 32.
17. Wyckoff MH, Wyllie J, Aziz K, et al. Neonatal life support: 2020 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science with Treatment Recommendations. Circulation, 2020, 142(16_Suppl_1): S185-S221.
18. Perlman JM, Wyllie J, Kattwinkel J, et al. Part 11: neonatal resuscitation: 2010 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science with Treatment Recommendations. Circulation, 2010, 122(16 Suppl 2): S516-S538.
19. Bancalari A, Díaz V, Araneda H. Effects of pharyngeal suction on the arterial oxygen saturation and heart rate in healthy newborns delivered by elective cesarean section. J Neonatal Perinatal Med, 2019, 12(3): 271-276.
20. Kelleher J, Bhat R, Salas AA, et al. Oronasopharyngeal suction versus wiping of the mouth and nose at birth: a randomised equivalency trial. Lancet, 2013, 382(9889): 326-330.
21. Pocivalnik M, Urlesberger B, Ziehenberger E, et al. Oropharyngeal suctioning in neonates immediately after delivery: influence on cerebral and peripheral tissue oxygenation. Early Hum Dev, 2015, 91(2): 153-157.
22. International Liaison Committee on Resuscitation. 2005 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science with Treatment Recommendations. Part 7: neonatal resuscitation. Resuscitation, 2005, 67(2/3): 293-303.
23. Kattwinkel J, Niermeyer S, Nadkarni V, et al. ILCOR advisory statement: resuscitation of the newly born infant. An advisory statement from the pediatric working group of the International Liaison Committee on Resuscitation. Circulation, 1999, 99(14): 1927-1938.
24. Guinsburg R, de Almeida MFB, Finan E, et al. Tactile stimulation in newborn infants with inadequate respiration at birth: a systematic review. Pediatrics, 2022, 149(4): e2021055067.
25. Baik-Schneditz N, Urlesberger B, Schwaberger B, et al. Tactile stimulation during neonatal transition and its effect on vital parameters in neonates during neonatal transition. Acta Paediatr, 2018, 107(6): 952-957.
26. Dekker J, Hooper SB, Martherus T, et al. Repetitive versus standard tactile stimulation of preterm infants at birth: a randomized controlled trial. Resuscitation, 2018, 127: 37-43.
27. Pietravalle A, Cavallin F, Opocher A, et al. Neonatal tactile stimulation at birth in a low-resource setting. BMC Pediatr, 2018, 18(1): 306.
28. Cavallin F, Lochoro P, Ictho J, et al. Corrigendum to “Back rubs or foot flicks for neonatal stimulation at birth in a low-resource setting: a randomized controlled trial” [Resuscitation 167 (2021) 137-143]. Resuscitation, 2021, 169: 314.
29. Kc A, Peven K, Ameen S, et al. Neonatal resuscitation: EN-BIRTH multi-country validation study. BMC Pregnancy Childbirth, 2021, 21(Suppl 1): 235.
30. Abbey NV, Mashruwala V, Weydig HM, et al. Electrocardiogram for heart rate evaluation during preterm resuscitation at birth: a randomized trial. Pediatr Res, 2022, 91(6): 1445-1451.
31. Katheria A, Arnell K, Brown M, et al. A pilot randomized controlled trial of EKG for neonatal resuscitation. PLoS One, 2017, 12(11): e0187730.
32. Shah BA, Wlodaver AG, Escobedo MB, et al. Impact of electronic cardiac (ECG) monitoring on delivery room resuscitation and neonatal outcomes. Resuscitation, 2019, 143: 10-16.
33. Celebi MY, Alan S, Kahvecioglu D, et al. Impact of prophylactic continuous positive airway pressure on transient tachypnea of the newborn and neonatal intensive care admission in newborns delivered by elective cesarean section. Am J Perinatol, 2016, 33(1): 99-106.
34. Osman AM, El-Farrash RA, Mohammed EH. Early rescue Neopuff for infants with transient tachypnea of newborn: a randomized controlled trial. J Matern Fetal Neonatal Med, 2019, 32(4): 597-603.
35. Hishikawa K, Goishi K, Fujiwara T, et al. Pulmonary air leak associated with CPAP at term birth resuscitation. Arch Dis Child Fetal Neonatal Ed, 2015, 100(5): F382-387.
36. Smithhart W, Wyckoff MH, Kapadia V, et al. Delivery room continuous positive airway pressure and pneumothorax. Pediatrics, 2019, 144(3): e20190756.
37. Pejovic NJ, Myrnerts Höök S, Byamugisha J, et al. A randomized trial of laryngeal mask airway in neonatal resuscitation. N Engl J Med, 2020, 383(22): 2138-2147.
38. Pejovic NJ, Trevisanuto D, Lubulwa C, et al. Neonatal resuscitation using a laryngeal mask airway: a randomised trial in Uganda. Arch Dis Child, 2018, 103(3): 255-260.
39. Trevisanuto D, Cavallin F, Nguyen LN, et al. Supreme laryngeal mask airway versus face mask during neonatal resuscitation: a randomized controlled trial. J Pediatr, 2015, 167(2): 286-291.
40. Pejovic NJ, Cavallin F, Mpamize A, et al. Respiratory monitoring during neonatal resuscitation using a supraglottic airway device vs. a face mask. Resuscitation, 2022, 171: 107-113.
41. Schmölzer GM, Morley CJ, Wong C, et al. Respiratory function monitor guidance of mask ventilation in the delivery room: a feasibility study. J Pediatr, 2012, 160(3): 377-381.
42. van Zanten HA, Kuypers KLAM, van Zwet EW, et al. A multi-centre randomised controlled trial of respiratory function monitoring during stabilisation of very preterm infants at birth. Resuscitation, 2021, 167: 317-325.
43. Zeballos Sarrato G, Sánchez Luna M, Zeballos Sarrato S, et al. New strategies of pulmonary protection of preterm infants in the delivery room with the respiratory function monitoring. Am J Perinatol, 2019, 36(13): 1368-1376.

West China Medical Journal

Interpretation of the updates in the pediatric and neonatal life support in 2022 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science with Treatment Recommendations

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content