Intact survival in extremely low birth weight infants after delivery room resuscitation.
OBJECTIVE
None of the 20 previously reported infants weighing <750 g at birth who received cardiopulmonary resuscitation (CPR) in the delivery room (DR) survived. To clarify whether such resuscitation is futile in our center, we evaluated our experience with DR-CPR over a 4-year period.


METHODS
We retrospectively reviewed the outcomes of all inborn infants with birth weights <1000 g at University of California, San Diego Medical Center from January 1993 to December 1996. Surviving infants and matched control infants were followed for </=40 months' adjusted age using standardized neurodevelopmental assessments.


RESULTS
Of the infants with birth weight <1000 g born during this period, 29% (51/177) died, including 44% of those <750 g and 16% of those >/=750 g. Overall, 19 infants received DR-CPR, of whom 12 were <750 g. Of the infants who received DR-CPR, 79% (15/19) survived, including 10 of 13 infants <750 g and 5 of 6 infants >/=750 g. Of the 15 survivors, 10 were followed beyond 10 months' adjusted age (median: 28 months). At last examination, 70% were both neurologically and developmentally normal. Two infants had cerebral palsy with mild cognitive and severe motor developmental delay. Of 7 infants with birth weight <750 g, 6 had normal neurodevelopmental outcomes. The mean composite mental and motor scores of DR-CPR survivors were 93 +/- 10 and 89 +/- 25, respectively. No differences were found in neurologic or developmental outcome between DR-CPR survivors and control infants matched for gestational age, sex, and year of birth.


CONCLUSIONS
Our results indicate that intact survival is possible for infants weighing <750 g at birth after DR-CPR.
Finer
N N
NN
Division of Neonatology, Department of Pediatrics, University of California, San Diego, California 92103-8774, USA.
Tarin
T
T
Vaucher
Y E
YE
Barrington
K
K
Bejar
R
R
D016887:Cardiopulmonary Resuscitation; D002657:Child Development; D003696:Delivery Rooms; D002658:Developmental Disabilities; D004837:Epinephrine / Q000627:therapeutic use; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age; D019102:Infant, Very Low Birth Weight; D008297:Male; D018447:Medical Futility; D009483:Neuropsychological Tests; D012189:Retrospective Studies; D017741:Survivors
D004837:Epinephrine