Villani P, Di Fabio S, Torielli F, Gizzi C, Martano C
Minerva Pediatr. 2010 Jun;62(3 Suppl 1):225-6.
WHO has estimated that as many as 10% of all newborn infants need some intervention at birth and approximately 1% more extensive intervention. If this is correct, up to 13-14 million of the world's annual newborn infants need intervention and of these approximately 1.5 million will need intensive therapy. Each year at least 1.16 million newborn babies die in sub-Saharan Africa. This region has the highest risk of newborn deaths and the slowest progress in reducing mortality. The transition from intrauterine to extrauterine life is extremely hazardous, with probably more radical physiologic adjustments required during and immediately following the birth process than at any other point in a human lifetime. Although certain episodes of fetal asphyxia cannot be prevented a prompt and skilled resuscitation may prevent lifelong adverse sequelae. Optimal resuscitation procedures should therefore become high priority. The ILCOR, the AHA and the AAP have established their new guidelines for newborn resuscitation on review of the evidence for each step. There still are a number of unanswered questions regarding newborn resuscitation (the ideal ratio of chest compressions to ventilation, the benefits and risks of supplementary oxygen, the indications for volume therapy, the optimal glucose level in infants that required resuscitation, the better ventilation in a newborn at birth.
世界卫生组织估计，多达10%的新生儿在出生时需要某种干预，约1%需要更广泛的干预。如果这一数据准确，那么全球每年有多达1300万至1400万新生儿需要干预，其中约150万需要重症治疗。每年至少有116万新生儿在撒哈拉以南非洲地区死亡。该地区新生儿死亡风险最高，在降低死亡率方面进展最慢。从子宫内生活过渡到子宫外生活极其危险，出生过程中和出生后立即需要进行的生理调整可能比人生任何其他阶段都更为剧烈。尽管某些胎儿窒息情况无法预防，但及时、熟练的复苏可预防终身不良后果。因此，最佳复苏程序应成为高度优先事项。国际复苏联络委员会（ILCOR）、美国心脏协会（AHA）和美国儿科学会（AAP）在审查每一步骤的证据后制定了新生儿复苏新指南。关于新生儿复苏仍有许多未解答的问题（胸外按压与通气的理想比例、补充氧气的利弊、容量治疗的指征、需要复苏的婴儿的最佳血糖水平、新生儿出生时更好的通气方式）。
