Resuscitation of the newborn development of algorithms, present status and future perspectives

Annually 130-140 million neonates are born worldwide. Around 85% of those who are born at term initiate spontaneous respiration within 30 seconds and another 10% respond during drying and stimulation. Approximately 3-5% require positive pressure ventilation to initiate breathing. Even fewer need advanced resuscitation including an advanced airway (intubation or laryngeal mask airway), chest compressions, epinephrine, or volume therapy. The International Liaison Committee on Resuscitation (ILCOR) has developed an algorithm to aid in resuscitation of neonates. Anticipation, preparation, and stabilization are key for neonatal transition. Areas of importance are thermoregulation, respiratory support, heart rate detection, optimal oxygenation, and delayed cord clamping. In low-income areas the Helping Babies Breathe algorithm may be useful. Focusing on maternal health is a key to reducing the need for neonatal resuscitation. Teaching and debriefing are essential parts of any resuscitation program.