Grant: Travel Awards - Institute Community Support

In adults with heart arrest, it is recommended to perform uninterrupted heart massage. However, in newborn babies that need resuscitation, one should make a pause in the heart massage when an artificial breath is provided. This is because most babies who need resuscitation suffer from oxygen deficiency and heart massage may theoretically decrease the effect of the artificial breath if delivered at the same time. We do not know if this is really the case and it might be so that uninterrupted heart massage is better also in newborn babies. Today's recommendation is that the heart should be massaged three times before a pause is made and one artificial breath with pure oxygen is provided (a 3:1 ratio of heart massage to artificial breaths). Pure oxygen is used even though we do not have evidence that this is better than using air. Pure oxygen may in fact be harmful to the baby as it might cause chemical reactions in the cells that can affect the future health of the baby. In this study we used newborn pigs with heart arrest caused by oxygen deprivation to compare the currently recommended 3:1 ratio of heart massage to artificial breaths with uninterrupted heart massage with either air or pure oxygen. We found that air was as effective as pure oxygen in causing the heart to start beating again in these pigs. In terms of the time required to get the heart to start beating again and survival, uninterrupted heart massage was not better than the 3:1 ratio of heart massage to artificial breaths. The results of our study confirm the assumption that heart arrest in newborn babies differs from heart arrest in adults. Extrapolating evidence from adults to newborns is inappropriate and more research on newborn resuscitation is needed. According to our results, due to the possible harmful effect of pure oxygen, air can or even should be used when heart massage is performed in newborn infants. Uninterrupted heart massage does not provide additional benefit.