Kattwinkel J, Niermeyer S, Nadkarni V, Tibballs J, Phillips B, Zideman D, Van Reempts P, Osmond M
American Academy of Pediatrics.
Pediatrics. 1999 Apr;103(4):e56. doi: 10.1542/peds.103.4.e56.
The International Liaison Committee on Resuscitation (ILCOR), with representation from North America, Europe, Australia, New Zealand, Africa, and South America, was formed in 1992 to provide a forum for liaison between resuscitation organizations in the developed world. This consensus document on resuscitation extends previously published ILCOR advisory statements on resuscitation to address the unique and changing physiology of the newly born infant within the first few hours after birth and the techniques for providing advanced life support. After careful review of the international resuscitation literature and after discussion of key and controversial issues, consensus was reached on almost all aspects of neonatal resuscitation, and areas of controversy and high priority for additional research were delineated. Consensus on resuscitation for the newly born infant included the following principles: Common or controversial medications (epinephrine, volume expansion, naloxone, bicarbonate), special resuscitation circumstances affecting care of the newly born, continuing care of the newly born after resuscitation, and ethical considerations for initiation and discontinuation of resuscitation are discussed. There was agreement that insufficient data exist to recommend changes to current guidelines regarding the use of 21% versus 100% oxygen, neuroprotective interventions such as cerebral hypothermia, use of a laryngeal mask versus endotracheal tube, and use of high-dose epinephrine. Areas of controversy are identified, as is the need for additional research to improve the scientific justification of each component of current and future resuscitation guidelines.
国际复苏联合委员会(ILCOR)于1992年成立,成员来自北美、欧洲、澳大利亚、新西兰、非洲和南美洲,旨在为发达国家的复苏组织提供一个联络论坛。这份关于复苏的共识文件扩展了ILCOR先前发布的关于复苏的咨询声明,以应对出生后最初几个小时内新生儿独特且不断变化的生理学特征以及提供高级生命支持的技术。在仔细审查国际复苏文献并讨论关键和有争议的问题后,就新生儿复苏的几乎所有方面达成了共识,并划定了有争议的领域和需要进一步研究的高度优先领域。关于新生儿复苏的共识包括以下原则:讨论了常用或有争议的药物(肾上腺素、扩容、纳洛酮、碳酸氢盐)、影响新生儿护理的特殊复苏情况、复苏后新生儿的持续护理以及复苏开始和停止的伦理考量。大家一致认为,现有数据不足以建议改变当前关于使用21%氧气与100%氧气、诸如亚低温等神经保护干预措施、使用喉罩与气管插管以及使用高剂量肾上腺素的指南。确定了有争议的领域,以及开展更多研究以改善当前和未来复苏指南各组成部分科学依据的必要性。