Thread by @EBNEO

Drs. Myra Wyckoff @UTSWNews and Jonathan Wyllie provide an update on @Ilcor_org guidelines for neonatal life support #HotTopicsNeo2020 #neoEBM

Here is a link to the summary of updated guidelines: ahajournals.org/doi/10.1161/CI…

Recommendation (weak) against routine direct laryngoscopy and tracheal suctioning for non-vigorous newborn infants delivered through meconium-stained amniotic fluid

For sustained inflation, @Ilcor_org provide a weak recommendation against sustained inflation for preterm infants based on possibility of harm (RR mortality with sustained inflation 1.38; 1.00-1.91 in subgroup of infants <28 weeks' gestation #neoEBM

Here is the @Ilcor_org recommendations for sustained inflation, with no recommendation for term or late preterm infant

Regarding initial oxygen targets in preterm infants, the Torpedo trial (Oei et al., stopped for futility, with potential for high risk of bias) pubmed.ncbi.nlm.nih.gov/28034908/ showed different treatment effects from prior studies

The @Ilcor_org guidelines provide a weak recommendation to start with a lower oxygen target (21-30%) compared to higher (60-100%) for preterm infants <35 weeks' gestation, based on the very low certainty of evidence

Dr. Wyllie does highlight some of the gaps in knowledge and uncertainty in evidence of oxygen saturation targets

Regarding duration of resuscitation, @Ilcor_org provided a narrative recommendation, informed by a recent systematic-review and meta-analysis by Dr. Foglia pubmed.ncbi.nlm.nih.gov/32788267/

Thank you to @Ilcor_org and the community of over 50 members from around the world that help to synthesize the evidence for neonatal resuscitation and provide essential guidance to the global neonatal community