ArticlePediatric research2026
Neonatal resuscitation for bradycardia (HR < 60 bpm)-an alternate approach using an ovine model.
Article in Pediatric research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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Who cites it
1 citing paper in PubMed.
- Dextrose with Insulin During Neonatal Resuscitation for Prolonged Asphyxia in a Near-Term Ovine Model: A Proof-of-Concept Study.Children (Basel, Switzerland) · 2025Article
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9 authors.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundThe International Liaison Committee on Resuscitation recommends initiating chest compressions (CC) in newborns when heart rate (HR) is <60 beats per minute (bpm) after 30 s of effective positive pressure ventilation (PPV).
methodsNear-term lambs with asphyxia induced bradycardia (HR < 60 bpm) were randomized to: (i) control (n = 6)- Resuscitation per current Neonatal Resuscitation Program (NRP) (ii) study (n = 6)-PPV continued until HR = 0, only then CC with PPV were administered in a ratio of 3:1 until return of spontaneous circulation (ROSC). Outcomes included timing, incidence of ROSC, CC requirement, blood gases, and peak coronary, carotid, and pulmonary blood flow.
resultsThe time to achieve ROSC was not different between groups (3 ± 2 min vs. 1.6 ± 1 min in study (p = 0.17). Only 1/6 lambs in study group required CC versus 6/6 in control group (p = 0.015). At ROSC, the study group had significantly lower arterial PaCO2 (47 ± 5 mmHg vs. 94 ± 18 mmHg, p < 0.01) and higher arterial PaO
conclusionPrioritizing ventilation during bradycardia reduced need for CC, facilitated faster ROSC, and improved gas exchange in an ovine model. IMPACT: Prioritizing ventilation over chest compressions beyond 30 s for bradycardia during neonatal resuscitation improves outcomes, reducing the need for chest compressions and accelerating the time to return of spontaneous circulation. Pulseless electrical activity occurs before complete cardiac arrest. Focusing on initiating chest compressions at a specific heart rate will distract providers from prioritizing ventilation.
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