Schierholz Elizabeth, Wetzel Elizabeth A, Thomas Alyssa R, Kamath-Rayne Beena D, Reed Danielle J W
Neonatal Nurse Practitioner, Nurse Scientist, Children's Hospital Colorado, Aurora, CO, USA.
Associate Professor of Clinical Pediatrics, Department of Pediatrics, Division of Neonatal-Perinatal Medicine, Indiana University School of Medicine, Indianapolis, IN, USA.
Semin Perinatol. 2024 Dec;48(8):151991. doi: 10.1016/j.semperi.2024.151991. Epub 2024 Oct 9.
The Neonatal Resuscitation Program (NRP) is the most used resuscitation algorithm for infants requiring resuscitation in the neonatal intensive care unit (NICU). The population of infants cared for in the NICU is varied and complex with resuscitation needs that may extend beyond the NRP algorithm. To provide resuscitation care that addresses these needs, institutions may choose to incorporate algorithms from the Pediatric Advanced Life Support or a "hybrid" approach that includes NRP. Limited evidence exists to support one algorithm or approach over another. In this article, we identify potential gaps in the application of using NRP or PALS in the NICU population, present select patient decompensations and discuss the resuscitation management approach using the NRP or PALS algorithms. Challenges associated with NICU resuscitation education will be explored as well as approaches to overcome some of the identified resuscitation education obstacles.
新生儿复苏项目(NRP)是新生儿重症监护病房(NICU)中对需要复苏的婴儿使用最多的复苏算法。NICU中接受护理的婴儿群体多样且复杂,其复苏需求可能超出NRP算法的范围。为了提供能满足这些需求的复苏护理,医疗机构可能会选择纳入儿科高级生命支持的算法或采用包括NRP在内的“混合”方法。支持一种算法或方法优于另一种的证据有限。在本文中,我们确定了在NICU人群中应用NRP或儿科高级生命支持(PALS)时存在的潜在差距,介绍了特定的患者失代偿情况,并讨论了使用NRP或PALS算法的复苏管理方法。还将探讨与NICU复苏教育相关的挑战以及克服一些已确定的复苏教育障碍的方法。