Pathophysiology of neonatal resuscitation: application in a global context.

Despite the adoption of evidence-based guidelines for neonatal resuscitation, formulated with international consensus, the process of resuscitating a newly born infant remains a uniquely local activity. Variations in the physical environment, cultural and medical beliefs, and available resources mediate significant difference in practices worldwide. Yet, the universal nature of the physiology surrounding birth, and its disturbances, provides a common basis for reference. Recognition of the importance of assistance available at the moment of birth, management of the thermal environment, and establishment of adequate ventilation is nearly universal. Differences in specific practices arise from local differences in the risks and challenges to perinatal health, which, in turn, stem from the environment or the available resources. Valuable information can be learned through comparison and evaluation of different techniques. In such a way, the evidence base for neonatal resuscitation can be strengthened and infants around the world can share in the benefits realized.