There is a large body of evidence demonstrating that delaying clamping of the umbilical cord provides benefits for term and preterm infants. These benefits include reductions in mortality in preterm infants and improved developmental scores at 4 years of age in term infants. However, non-breathing or non-vigorous infants at birth are excluded due to the perceived need for immediate resuscitation. Recent studies have demonstrated early physiological benefits in both human and animal models if resuscitation is performed with an intact cord, but this is still an active area of research. Given the large number of ongoing and planned trials, we have brought together an international group that have been intimately involved in the development or use of resuscitation equipment designed to be used while the cord is still intact. In this review, we will present the benefits and limitations of devices that have been developed or are in use. Published trials or ongoing studies using their respective devices will also be reviewed.
Bibliographical noteFunding Information:
In collaboration with biomedical engineers with Alberta Health Services, Canada in 2014, researchers in Calgary developed a resuscitation trolley to be used to initiate resuscitative care for newborns while on placental circulation. The trolley—Integrated Neonatal Support on Placental Circulation with Resuscitation (INSPiRe) was a height-adjustable resuscitation platform mounted with standard newborn resuscitative equipment and was independent of external power or gas supplies. Development of this battery-powered mobile, medical grade steel resuscitation platform equipped with a scale, pre-warmed gel mattress, oxygen and air tanks, blender, T-piece resuscitator, pulse oximeter and suction device was funded by the section of neonatology.
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