RT Book, Section
A1 Meredith, Keith S.
A1 Patel, Pranav
A2 Foley, Michael R.
A2 Strong, Jr., Thomas H.
A2 Garite, Thomas J.
SR Print(0)
ID 1115791803
T1 Neonatal Resuscitation: Pathophysiology, Organization, and Survival
T2 Obstetric Intensive Care Manual, 4e
YR 2015
FD 2015
PB McGraw-Hill Education
PP New York, NY
SN 9780071820134
LK obgyn.mhmedical.com/content.aspx?aid=1115791803
RD 2024/04/24
AB Each  year,  an  estimated  23%  of  the  3.5  million  neonatal  deaths  that  occur  worldwide  are  the  result  of  birth  asphyxia.  In  the  United  States,  preliminary  3.9  million  children  are  born  annually,  with  a  reported  infant  mortality  rate  of  6.11  for  the  year  2011.1,2  This  suggests  that  every  year,  among  US  children  who  reach  28  weeks’  gestation,  over  26,000  die  prior  to  their  seventh  day  of  life.  A  significant  portion  of  those  infants  who  succumb  do  so  from  birth  asphyxia.  Further,  among  children  reaching  term  gestation,  2  to  3  per  1000  live  term  births  suffer  hypoxic  ischemic  encephalopathy  (HIE),  (0.3  per  1000  severe  HIE).  (Table  24-1)  Up  to  80%  of  infants  who  survive  severe  hypoxic-ischemic  encephalopathy  develop  serious  complications  and  10%  to  20%  develop  moderately  serious  disabilities.  In  addition,  it  is  widely  accepted  that  10%  of  all  newborns  require  some  assistance  to  begin  and  maintain  normal  breathing  and  that  1%  require  aggressive  resuscitation.  Thus,  using  the  national  birth  rate  data,  annually  400,000  newborns  need  some  help  during  the  perinatal  period,  40,000  per  year  require  expert  assistance  to  reverse  profound  cardiorespiratory  depression,  and  1200  per  year  develop  severe  HIE.  Although  there  is  some  evidence  that  therapeutic  hypothermia  is  beneficial  to  term  newborns  with  moderate  to  severe  hypoxic  ischemic  encephalopathy,  and  that  cooling  decreases  death  without  increasing  major  disability  in  survivors,  this  therapy  is  not  available  at  all  centers  yet  as  further  research  is  being  compiled.  (Table  24-2).