SynthesisJournal of perinatology : official journal of the California Perinatal Association2025
Threshold to initiate chest compressions for bradycardia at birth: A narrative review.
Synthesis in Journal of perinatology : official journal of the California Perinatal Association, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
2 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Singapore Neonatal Resuscitation Guidelines 2026.Singapore medical journal · 2026Guideline
- RECOVER Guidelines: Newborn Resuscitation in Dogs and Cats. Evidence and Knowledge Gap Analysis With Treatment Recommendations.Journal of veterinary emergency and critical care (San Antonio, Tex. : 2001) · 2025Pooled it
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Neonatal resuscitation guidelines recommend initiating chest compressions (CC) in newborns at birth if heart rate (HR) remains <60 bpm after 30 s of ventilation. This threshold is based on expert opinion and scant animal data. Our aim was to systematically evaluate the existing evidence and appraise current insights regarding thresholds for starting CC during bradycardia at birth. A recent scoping review synthesized the evidence on various aspects of neonatal CC until November 2021. We updated this review, focusing on HR thresholds for CC, with a new systematic literature search in MEDLINE, Embase, and the Cochrane Database of Systematic Reviews until March 2024. No studies comparing HR thresholds for CC commencement at birth were identified. Consequently, we decided to review the literature more narratively, covering a wider range of topics within this subject matter. Relevant papers from the initial search were used and additional sources of information were sought using snowballing procedures. Numerous publications were identified, containing pathophysiological considerations, in vitro experiments, animal data, and some human data. Preliminary findings from a recent mathematical model study conducted in our center were also briefly considered. All this information enabled a thorough discussion on the rationale for CC during neonatal bradycardia. Finally, a survey was disseminated among knowledgeable neonatal clinicians and researchers to evaluate their perspectives on initiating CC for neonatal bradycardia. Of 183 survey respondents, 137 (74.9%) indicated they would wait longer than the currently recommended 30 s of assisted ventilation before starting CC in newborns with a HR (rising) between 30 and 60 bpm, acknowledging effective ventilation as a priority. We conclude that clinical evidence is lacking, though reconsideration of the threshold to initiate CC for bradycardia at birth seems justified based on available data. This is supported by the views of many surveyed professionals. Randomized trials in human infants and appropriate newborn animal models are warranted.
Indexed as
Identifiers
40360699What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.