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)