[Resuscitation in very low birth weight and extremely low birth weight newborns in the delivery room].
OBJECTIVE
Of the study is to discuss the need of delivery room cardio-pulmonal resuscitation (DR-CPR) in VLBW and ELBW infants and intensity, to determine its prognostic significance for the neonatal outcomes, and the influence of some perinatal criteria.


METHODS
A retrospective study is performed in University Maternity Hospital: Maichin Dom", for the years 1998-1999 including: 61 ELBW (500-999 g) and 122 VLBW (1000-1499 g). Excluded are infants with great malformations.


RESULTS
There were 54% survivors in the ELBW and 86.1% in the VLBW group. 1-st min Apgar scores were significantly lower in the ELBW-group 3.5 +/- 1.9 in comparison to the VLBW: 4.9 +/- 1.9 = pH from umbilical artery were lower too: 7.19 +/- 0.16 and 7.24 +/- 0.14 respectively. From 12 ELBW babies with cord arterial pH < 7.1 survived only 3, but all 3 with pH < 7.0 died; 8 from 10 VLBW babies with pH < 7.1 survived. Intubation rates were as followed: ELBW group--82%, 70% in the first 5 min; VLBW group--57% and 34% respectively. Adrenalin and/or chest compression received 6 ELBW infants, 5 of who died and 4 had severe IVH. The same resuscitation received 8 VLBW babies, 4 of who died and 2 survivors had 3-4 grade IVH. Any grade of IVH occurred in 65% of ELBW and in 44% of VLBW infants. Severe IVH was seen in 37% and 16% respectively. Overall, survivors with grade 3-4 IVH were 15% among the ELBW group and 7.6% among the VLBW.


CONCLUSIONS
Birth weight and gestational age are the most important factors, determining the intensity of DR-CPR and the prognosis in newborns of < 1500 g. Low Apgar scores, cord arterial pH < 7.10, the need of Adrenaline application and/or chest compression by DR-CPR are reliable prognostic criteria for death and poor nevrodevelopmental outcome.
Vakrilova
L
L
University Maternity Hospital Maichin Dom, Sofia, Bulgaria.
Kalaĭdzhieva
M
M
Slŭncheva
B
B
Popivanova
A
A
Metodieva
V
V
Garnizov
T
T
D016887:Cardiopulmonary Resuscitation / Q000706:statistics & numerical data*; D003696:Delivery Rooms; D006801:Humans; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight; D011379:Prognosis; D012189:Retrospective Studies; D016896:Treatment Outcome
Sŭstoianie pri razhdaneto, spetsifika i obem na reanimatsiiata v rodilna zala pri novorodeni s mnogo nisko i ekstremno nisko teglo.