Soni Pankaj, Nagalli Manjunath Mallikarjuna
Department of Neonatology, Thumbay University Hospital, Ajman, UAE.
Department of Clinical Sciences (Pediatric Neonatology), College of Medicine, Gulf Medical University, Ajman, UAE.
Eur J Pediatr. 2025 Mar 19;184(4):258. doi: 10.1007/s00431-025-06087-8.
Neonatal resuscitation practices have undergone tremendous changes over the past two decades, with progress accelerating due to advances in medical technology, scientific research, and improvements in clinical practices. Among other global frameworks, the neonatal resuscitation program has been periodically updated to incorporate evidence-based interventions aimed at improving survival rates, reducing morbidity and enhancing long-term health outcomes for newborns. This review traces the historical development of neonatal resuscitation guidelines from the early days' resuscitation practices of the mid-twentieth century to the present day. It narrates how clinical needs, emerging technologies, and scientific discoveries have shaped the evolution of these guidelines and practices. By reviewing recent guidelines, such as those issued by the American Heart Association and the World Health Organization, this article sheds light on the current core principles of neonatal resuscitation, including effective airway management, appropriate ventilation techniques, and the critical importance of timely intervention. The major determinants of changes in guidelines, as identified through this review, include advancements in scientific research, expert opinion, and international collaboration. Challenges in implementing these guidelines, particularly in low-resource settings, are discussed, along with case studies that demonstrate the impact of updated practices in real-world clinical environments.
The review concludes with a reflection on the continued need for research to close remaining gaps and enhance neonatal resuscitation practices across diverse global contexts.
• Effective neonatal resuscitation significantly improves outcomes by reducing neonatal mortality and morbidity. • Neonatal resuscitation program provides standardized protocols to implement these resuscitation skills.
• Simulation-based training and real-time feedback can bridge the gap between theoretical guidelines and practical application. • Despite advances in knowledge and application of these guidelines, challenges persist, such as regional differences, lack of resources in lower-income countries, and ideal ventilation devices and oxygenation methods.
在过去二十年中，新生儿复苏实践发生了巨大变化，由于医疗技术进步、科学研究以及临床实践改进，进展加速。在其他全球框架中，新生儿复苏项目定期更新，纳入基于证据的干预措施，旨在提高新生儿存活率、降低发病率并改善长期健康结局。本综述追溯了新生儿复苏指南从20世纪中叶早期复苏实践到当今的历史发展。它讲述了临床需求、新兴技术和科学发现如何塑造了这些指南和实践的演变。通过回顾近期指南，如美国心脏协会和世界卫生组织发布的指南，本文阐明了新生儿复苏的当前核心原则，包括有效的气道管理、适当的通气技术以及及时干预的至关重要性。通过本综述确定的指南变化的主要决定因素包括科学研究进展、专家意见和国际合作。讨论了实施这些指南的挑战，特别是在资源匮乏地区，并通过案例研究展示了更新实践在实际临床环境中的影响。
综述最后反思了持续开展研究以弥合剩余差距并在全球不同背景下加强新生儿复苏实践的必要性。
• 有效的新生儿复苏通过降低新生儿死亡率和发病率显著改善结局。
• 新生儿复苏项目提供实施这些复苏技能的标准化方案。
• 基于模拟的培训和实时反馈可弥合理论指南与实际应用之间的差距。
• 尽管在这些指南的知识和应用方面取得了进展，但挑战依然存在，如地区差异、低收入国家资源匮乏以及理想的通气设备和氧合方法。
