Grant: Early Career Investigator Awards - Circulatory and Respiratory Health

When newborn babies are born without a heartbeat the clinical team must provide breathing and chest compressions (what we call cardiopulmonary resuscitation) to the newborn baby. Cardiopulmonary resuscitation only happens in about 1% of deliveries. Despite cardiopulmonary resuscitation approximately one million newborn babies die at birth every year and newborn babies surviving cardiopulmonary resuscitation at birth have high rates of death and neurological impairment. The poor prognosis raises questions as to whether we can improve cardiopulmonary resuscitation methods and specifically adapt them to newborn babies to improve outcomes. Currently we use a 3:1 ratio, which equals 3 chest compressions to one rescue breath to resuscitate a newborn baby. 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 for the newborn baby and that chest compressions should be continued without interruption while rescue breaths are given continuously. We believe that this approach will allow us to reduce death and long-term burdens in newborn babies born without a heartbeat. The submitted proposal is a multi-center clinical trial, which will be performed at several sites across Canada and the rest of the world. In the delivery room of participating centers infants will be randomized to two different chest compression techniques to assess which technique improves their care. Our approach represents a unique way of delivering chest compression and rescue breaths for newborn infants. We hope that our approach will reduce death and long-term burdens in newborn babies born without a heartbeat. If validated, this will represent an important and novel approach for neonatal resuscitation, which can be adopted by clinicians in delivery rooms around the world. In summary, the results of this study could benefit many babies each year.