DELIVERY ROOM STABILIZATION. The Egyptian Consensus on the Management of Neonatal Respiratory Distress Syndrome 2017

NEONATAL CARE NETWORK 2017 (NCN

Recommendations

1.If possible delay clamping the umbilical cord for at least 60 seconds to promote placentofetal transfusion (B1).

2.Oxygen for resuscitation should be controlled using a blender. An initial concentration of 30%-60% oxygen is appropriate for babies <28 weeks’ gestation and 21–30% for those of 28–31 weeks, and adjustments up or down should be guided by pulse oximetry from birth (B2). Heart rate and saturation readings should be obtained from the right wrist immediately following birth (B).

3.In spontaneously breathing babies, stabilize with CPAP of at least 6 cm H 2 O via mask or nasal prongs (A1). Gentle positive pressure lung inflations using about 20–25 cm H 2 O peak inspiratory pressure should be used for persistently apneic or bradycardic infants (B1).

4.Intubation should be reserved for babies who have not responded to positive pressure ventilation (A1). Babies who require intubation for stabilization should be given surfactant (B1).

5. Plastic bags or occlusive wrapping under radiant warmers should be used during stabilization in the delivery suite for babies <32 weeks’ gestation to reduce the risk of hypothermia (A1).

6. Babies stabilized under a radiant heat warmer should be servo-controlled within 10 minutes to avoid over-heating. In the absence of servo-control, close monitoring of body temperature is required (B).

  • Qual­i­ty of evi­dence

   – High qual­i­ty A

   – Mod­er­ate qual­i­ty B

   – Low qual­i­ty C

   – Very low qual­i­ty D

MODIFIED FROM:

Euro­pean Con­sen­sus Guide­lines on the Man­age­ment of Res­pi­ra­to­ry Dis­tress Syn­drome – 2016 Update

Spon­sored by: abb­vie EGYPT

Shar­ing pro­fes­sors:

  • Prof Abdel Rah­man El Mashad (Tan­ta univ)
  • Prof Afaf Kor­raa (Azhar univ)
  • Prof El Sayed Kha­laf (Port fouad hosp, min­istry of health)
  • Prof Iman Eskan­der (Cairo univ)
  • Prof Hes­ham Abdel Hady (Man­soura univ)
  • Prof Hes­ham Ghaz­al (Alexan­dria univ)
  • Prof Mag­da Badawy (Cairo univ)
  • Prof Madi­ha Abdal­la (Minia univ)
  • Prof Magdy Kamel (Minia univ)
  • Prof M Abdel Aaal El Bagy (Sohag univ)
  • Prof Morad El Alfy (Al Galaa mil­i­tary cen­ter)
  • Prof Nahed Fah­my (Cairo univ)
  • Prof Nay­era Ismaeil (Ain Shams univ)
  • Prof Raguia Atwa (Ain Shams univ)
  • Prof Safaa Shafeek (Ain Shams univ)
  • Prof Sozan Gad (Suez canal univ)
  • Prof Osama Hus­sein (Port said neona­tol­ogy soci­ety)
  • Prof Osama Kasem (Al Galaa mil­i­tary cen­ter)
  • Prof Yehia Mah­moud Basha (Daman­hour teach­ing hosp)
  • Prof Zahraa Ezz El Deen (Cairo univ)