[Changes in the international recommendations on neonatal stabilisation and resuscitation (2015)]. / Adaptación de las recomendaciones internacionales en estabilización y reanimación neonatal 2015.

The International Liaison Committee on Resuscitation (ILCOR) recommendations provide a universal guide of measures to support the transition and resuscitation of newborn after their birth. This guide is expected to be adapted by local groups or committees on resuscitation, according to their own circumstances. The objective of this review is to analyse the main changes, to discuss several of the controversies that have appeared since 2010, and contrasting with other national and international organisations, such as European Resuscitation Council (ERC), American Heart Association (AHA), or the Australian-New Zealand Committee on Resuscitation (ANZCOR). Thus, the Neonatal Resuscitation Group of the Spanish Society of Neonatology (GRN-SENeo) aims to give clear answers to many of the questions when different options are available, generating the forthcoming recommendations of our country to support the transition and/or resuscitation of a newborn after birth, safely and effectively.

Reliability of Single-Use PEEP-Valves Attached to Self-Inflating Bags during Manual Ventilation of Neonates--An In Vitro Study.

INTRODUCTION: International resuscitation guidelines suggest to use positive end-expiratory pressure (PEEP) during manual ventilation of neonates. Aim of our study was to test the reliability of self-inflating bags (SIB) with single-use PEEP valves regarding PEEP delivery and the effect of different peak inflation pressures (PIP) and ventilation rates (VR) on the delivered PEEP. METHODS: Ten new single-use PEEP valves from 5 manufacturers were tested by ventilating an intubated 1 kg neonatal manikin containing a lung model with a SIB that was actuated by an electromechanical plunger device. Standard settings: PIP 20 cmH2O, VR 60/min, flow 8 L/min. PEEP settings of 5 and 10 cmH2O were studied. A second test was conducted with settings of PIP 40 cmH2O and VR 40/min. The delivered PEEP was measured by a respiratory function monitor (CO2SMO+). RESULTS: Valves from one manufacturer delivered no relevant PEEP and were excluded. The remaining valves showed a continuous decay of the delivered pressure during expiration. The median (25th and 75th percentile) delivered PEEP with standard settings was 3.4(2.7-3.8) cmH2O when set to 5 cmH2O and 6.1(4.9-7.1) cmH2O when set to 10 cmH2O. Increasing the PIP from 20 to 40 cmH2O led to a median (25th and 75th percentile) decrease in PEEP to 2.3(1.8-2.7) cmH2O and 4.3(3.2-4.8) cmH2O; changing VR from 60 to 40/min led to a PEEP decrease to 2.8(2.1-3.3) cmH2O and 5.0(3.5-6.2) cmH2O for both PEEP settings. CONCLUSION: Single-use PEEP valves do not reliably deliver the set PEEP. PIP and VR have an effect on the delivered PEEP. Operators should be aware of these limitations when manually ventilating neonates.

Continuous glucose monitoring in infants of very low birth weight.

OBJECTIVES: To evaluate the feasibility and efficacy of a continuous glucose monitoring system (CGMS) in a population of infants of very low birth weight (VLBW). STUDY DESIGN: Infants weighing