Manchineni Sai Bhavani, Meshram Revat J
Pediatrics, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND.
Cureus. 2024 Sep 8;16(9):e68924. doi: 10.7759/cureus.68924. eCollection 2024 Sep.
Neonatal resuscitation is a critical procedure aimed at ensuring the successful transition of newborns from intrauterine to extrauterine life. Traditionally, this involves immediate clamping and cutting of the umbilical cord, but recent advances have introduced intact cord resuscitation (ICR) as an alternative approach. This review aims to comprehensively analyze ICR, exploring its evolution, scientific basis, and clinical evidence. It seeks to evaluate the benefits and challenges associated with ICR and assess its impact on neonatal outcomes compared to traditional practices. A thorough review of the literature was conducted, including historical perspectives on neonatal resuscitation, the physiological rationale behind ICR, and critical clinical studies and trials. Current guidelines and recommendations were also examined, along with technological advancements and practical implementation issues. Evidence indicates that ICR offers significant benefits, including improved blood volume, better cardiovascular stability, and reduced risk of anemia in newborns. Comparative studies suggest that ICR can enhance neonatal outcomes and support a smoother transition to extrauterine life. Despite these benefits, challenges related to implementation and adherence to new practices persist. ICR represents a promising advancement in neonatal care, potentially improving newborns' health outcomes. Continued research and refinement of guidelines are necessary to fully integrate ICR into standard practice and address existing implementation challenges. This review highlights the need for ongoing evaluation and adaptation of resuscitation practices to optimize neonatal health and care.
新生儿复苏是一项关键程序,旨在确保新生儿从宫内生活成功过渡到宫外生活。传统上,这包括立即夹紧并剪断脐带,但最近的进展引入了完整脐带复苏(ICR)作为一种替代方法。本综述旨在全面分析ICR,探讨其演变、科学依据和临床证据。它试图评估与ICR相关的益处和挑战,并评估其与传统做法相比对新生儿结局的影响。对文献进行了全面回顾,包括新生儿复苏的历史观点、ICR背后的生理原理以及关键的临床研究和试验。还审查了当前的指南和建议,以及技术进步和实际实施问题。证据表明,ICR具有显著益处,包括增加血容量、更好的心血管稳定性以及降低新生儿贫血风险。比较研究表明,ICR可以改善新生儿结局并支持向宫外生活的更平稳过渡。尽管有这些益处,但与实施和遵循新做法相关的挑战仍然存在。ICR是新生儿护理方面一项有前景的进展,有可能改善新生儿的健康结局。持续的研究和指南的完善对于将ICR完全纳入标准实践并解决现有的实施挑战是必要的。本综述强调了持续评估和调整复苏实践以优化新生儿健康和护理的必要性。