Resuscitation of premature infants: What are we doing wrong and can we do better?

Abstract

Neonatal resuscitation is based on experience with little evidence to support the methods advocated. Current guidelines make no distinction between the techniques for term and very premature infants. The guidelines support the use of 100%, cold, dry oxygen delivered with devices that provide variable peak inspiratory pressures and tidal volumes with no positive end-expiratory pressure (PEEP). It is possible that these techniques damage the lungs. Self-inflating resuscitation bags give no indication about leaks, produce variable inflating pressures, do not provide PEEP and cannot deliver prolonged inflations. Flow-inflating bags will not work if there is leak at the facemask and also have var..