title: Preterm resuscitation I: clinical approaches to improve management in delivery room.
abstract: Delivery room (DR-) management has a great potential to optimise quality of long term outcome in extremely preterm infants. However, a new conceptual framework that focuses on an individualised 'support of transition' rather than on 'resuscitation' is necessary. Video-recordings of DR-management represent a valuable tool to improve care. Recording combined with a structured feed-back should be introduced in step-wise approach in clinical routine. To describe the postnatal condition of groups of infants or to compare interventions in a research setting, a numerical score-- representing the sum of several objective findings--is required. The conventional Apgar-Score has severe limitations that restrict its applicability. The Specified-Apgar allows an assessment of infant's condition independent of interventions and regardless of gestational age. The Expanded-Apgar quantifies the interventions needed to achieve the condition described by the Specified-Apgar. In summary, beside a new conceptual framework an individualised monitoring and an objective assessment of DR-management are required.
authors.affiliation: Department for Neonatology and Pediatric Intensive Care, Children's Clinic of the University Hospital Carl Gustav Carus, Fetscherstrasse 74, Dresden, Germany. mario.ruediger@uniklinikum-dresden.de
authors.forename: Mario
authors.initials: M
authors.lastname: Rüdiger
authors.forename: Nicole
authors.initials: N
authors.lastname: Braun
authors.forename: Heidrun
authors.initials: H
authors.lastname: Gurth
authors.forename: Renate
authors.initials: R
authors.lastname: Bergert
authors.forename: Jürgen
authors.initials: J
authors.lastname: Dinger
mesh_terms: D001034:Apgar Score; D003696:Delivery Rooms; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D019370:Observation; D010346:Patient Care Management / Q000379:methods* / Q000458:organization & administration; D011787:Quality of Health Care / Q000592:standards*; D012151:Resuscitation; D014741:Video Recording