Schwarz Christoph E, Schwaberger Bernhard, Flore Alice Iride, Joyce Robert, Woodworth Simon, Adam Frederic, Dempsey Eugene M
Clinic of Neonatology, Center for Pediatric and Adolescent Medicine, University of Heidelberg, 69120 Heidelberg, Germany.
INFANT Research Centre, University College Cork, T12 K8AF Cork, Ireland.
Children (Basel). 2025 Mar 22;12(4):402. doi: 10.3390/children12040402.
During the first minutes of life, complex dynamic processes occur, facilitating a normal transition to ex utero life. In healthy term infants, these processes typically occur with minimal intervention required but are often more challenging for the preterm infant. These challenges involve not only the physiological processes encountered but also an organizational process: that of a team of healthcare providers led by a neonatologist, establishing a diagnosis based on clinical and technical information and initiating time-critical and potentially life-altering interventions. In this narrative review, we highlight the challenges of both processes. We explore the role and limitations of well-established and newer potential monitoring modalities, in particular respiratory function monitoring and cerebral near-infrared spectroscopy, to optimally inform the team in regards to physiological processes. We also evaluate the important role that human factors play in the process of decision-making. Both are important for optimal performance to enable successful transition and thereby reduce short- and long-term problems. We identify research goals to inform future studies to further optimize technological and human aspects in the first minutes of life.
在出生后的最初几分钟内，会发生复杂的动态过程，以促进向宫外生活的正常过渡。在健康的足月儿中，这些过程通常在只需极少干预的情况下即可发生，但对早产儿来说往往更具挑战性。这些挑战不仅涉及所遇到的生理过程，还涉及一个组织过程：即由新生儿科医生领导的医疗团队，根据临床和技术信息进行诊断，并启动时间紧迫且可能改变生命的干预措施。在这篇叙述性综述中，我们强调了这两个过程的挑战。我们探讨了成熟的和新的潜在监测方式的作用及局限性，特别是呼吸功能监测和脑近红外光谱技术，以便为团队提供有关生理过程的最佳信息。我们还评估了人为因素在决策过程中所起的重要作用。这两者对于实现最佳表现、促成成功过渡从而减少短期和长期问题都很重要。我们确定了研究目标，为未来的研究提供信息，以进一步优化出生后最初几分钟内的技术和人为因素方面。
