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Journal of Child Neurology
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Guidelines for Resuscitation in the Delivery Room of Extremely Preterm Infants

Giovanna Verlato, MD

Departments of Paediatrics and Gynecological Sciences and Human Reproduction, University Hospital of Padua, Padua, Italy, verlato{at}pediatria.unipd.it.

Daniela Gobber, MD

Departments of Paediatrics and Gynecological Sciences and Human Reproduction, University Hospital of Padua, Padua, Italy

Donatella Drago, MD

Departments of Paediatrics and Gynecological Sciences and Human Reproduction, University Hospital of Padua, Padua, Italy

Lino Chiandetti, MD

Departments of Paediatrics and Gynecological Sciences and Human Reproduction, University Hospital of Padua, Padua, Italy

Paola Drigo, MD

Departments of Paediatrics and Gynecological Sciences and Human Reproduction, University Hospital of Padua, Padua, Italy

Ethical problems related to intensive care of extremely preterm newborns of ≤ 25 weeks' gestational age and at risk of disability have been extensively debated. The Bioethical Committee of the Department of Paediatrics of the University Hospital of Padua organized and started a multidisciplinary group to release guidelines to help staff facing problems related to prematurity. The vitality limit, survival, outcome, and ethical aspects were analyzed. Consequently, we suggest the following: at 22 weeks' gestational age, the deliverance of comfort care only; at 23 weeks, in the presence of detectable vital signs, the practice of immediate intubation, respiratory support, and a reassessment of the neonatal conditions; and at 24 weeks, the provision of intubation, ventilatory support, and cardiovascular resuscitation. If the clinical age and anamnestic gestational age are different, we proceed according to the more advanced one. The importance of providing parents with correct information and the role of comfort care are outlined. (J Child Neurol 2004;19:31—34).

Journal of Child Neurology, Vol. 19, No. 1, 31-34 (2004)
DOI: 10.1177/088307380401900106011
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