Grant: Project Grant

When newborn babies are born without a heartbeat the clinical team must provide breathing and chest compressions (what is called cardiopulmonary resuscitation). Worldwide 3 million babies need cardiopulmonary resuscitation at birth, but 1 million newborn babies still die despite getting cardiopulmonary resuscitation. Babies who survive cardiopulmonary resuscitation at birth have high rates of brain damage. This puts a heavy burden on health resources as these babies often need hospital re-admission and long-term care. The poor prognosis raises questions as improved cardiopulmonary resuscitation methods specifically adapt for newborn babies can improve outcomes. The current technique uses a 3:1 ratio, which equals 3 chest compressions to one rescue breath. This means that we stop chest compressions after every 3rd compression to give one rescue breath. We believe that this interruption of chest compressions is bad and that chest compressions should be continued without interruption while rescue breaths are given continuously (we have called this technique CC+SI). We have studied this technique for more than 10 years in animal models and in two small clinical trials. Our studies have shown that the duration of chest compression is reduced with CC+SI and reduces death. Our proposal will fill a knowledge gap by conducting an international clinical trial comparing the current 3:1 ratio with CC+SI during cardiopulmonary resuscitation at birth. The cardiopulmonary resuscitations techniques have been selected using the best available knowledge. Both cardiopulmonary resuscitation techniques which will be randomly assigned to treat babies. After the trial we will determine which cardiopulmonary resuscitation technique gave babies better survival and health outcomes. Our research fills a critical knowledge gap in the care of newborn babies and will impact their survival both here in Canada and internationally.