Enhancing neonatal resuscitation outcomes: bridging theory and practice

Abstract

Neonatal resuscitation practices have undergone tremendous changes over the past two decades, with progress accelerating due to advances in medical technology, scientific research, and improvements in clinical practices. Among other global frameworks, the neonatal resuscitation program has been periodically updated to incorporate evidence-based interventions aimed at improving survival rates, reducing morbidity and enhancing long-term health outcomes for newborns. This review traces the historical development of neonatal resuscitation guidelines from the early days' resuscitation practices of the mid-twentieth century to the present day. It narrates how clinical needs, emerging technologies, and scientific discoveries have shaped the evolution of these guidelines and practices. By reviewing recent guidelines, such as those issued by the American Heart Association and the World Health Organization, this article sheds light on the current core principles of neonatal resuscitation, including effective airway management, appropriate ventilation techniques, and the critical importance of timely intervention. The major determinants of changes in guidelines, as identified through this review, include advancements in scientific research, expert opinion, and international collaboration. Challenges in implementing these guidelines, particularly in low-resource settings, are discussed, along with case studies that demonstrate the impact of updated practices in real-world clinical environments.

Conclusion: The review concludes with a reflection on the continued need for research to close remaining gaps and enhance neonatal resuscitation practices across diverse global contexts.

What is known: • Effective neonatal resuscitation significantly improves outcomes by reducing neonatal mortality and morbidity. • Neonatal resuscitation program provides standardized protocols to implement these resuscitation skills.

What is new: • Simulation-based training and real-time feedback can bridge the gap between theoretical guidelines and practical application. • Despite advances in knowledge and application of these guidelines, challenges persist, such as regional differences, lack of resources in lower-income countries, and ideal ventilation devices and oxygenation methods.

Keywords: Airway management; Clinical trials; Global variation; Guidelines; Low-resource settings; Medical advances; Neonatal care; Neonatal resuscitation program.

Fig. 1

Neonatal Resuscitation Program (NRP) steps (source: American Academy of Pediatrics and American Heart Association)

Fig. 2

Key clinical studies influencing guidelines