Favourable neurological outcomes following delivery room cardiopulmonary resuscitation of infants <= 750 g at birth

Objective: To study short- and long-term outcomes of infants less than or e qual to 750 g birthweight who received cardiopulmonary resuscitation (CPR) in the delivery room. Methodology: A retrospective analysis of all inborn live births less than o r equal to 750 g birthweight from 1990 to 1996. Cardiopulmonary resuscitati on was defined as positive pressure ventilation via an endotracheal tube an d chest compressions. Univariate analyses were conducted comparing patients according to the use of CPR or positive pressure ventilation alone. Results: Cardiopulmonary resuscitation was administered to 16 infants: four received chest compressions only and 12 also received adrenaline. Cardiopu lmonary resuscitation recipients had significantly lower Apgar scores at bo th 1 and 5 min, and had delayed onset of spontaneous respiration (P < 0.01) . Seven patients died, and eight of nine survivors were free of major neuro developmental abnormalities at follow up. All CPR recipients with a 5 min A pgar score of less than or equal to 5 and delayed onset of spontaneous resp iration beyond 5 min had poor outcomes. Conclusion: Contrary to the majority of published evidence, delivery room C PR in our extremely small infants was not associated with a high risk of se vere neurodevelopmental disability.