Preterm Infant Resuscitation Flashcards

What is the risk of providing excessive tidal volumes during PPV in a preterm infant, and how can this be mitigated?

Answer: Volutrauma from excessive tidal volumes causes alveolar overdistension and inflammatory lung injury, increasing risk of bronchopulmonary dysplasia

Volutrauma — lung injury from excessive tidal volumes — causes alveolar overdistension, epithelial disruption, and inflammatory mediator release that can lead to bronchopulmonary dysplasia (BPD) in preterm infants.

What is the rationale for using antenatal corticosteroids before preterm delivery, and how do they affect delivery room management?

Answer: Antenatal corticosteroids accelerate fetal lung maturation and surfactant production, reducing the severity of RDS and the need for delivery room interventions

Antenatal corticosteroids (betamethasone or dexamethasone) administered 24–48 hours before preterm delivery significantly accelerate lung maturation, increase surfactant production, and reduce the incidence and severity of RDS, IVH, and NEC.

What is 'gentle' chest rise in the context of PPV for preterm infants, and why is it important?

Answer: Slight, visible chest rise described as a gentle movement of the chest — indicates appropriate tidal volume without overdistension

NRP recommends aiming for slight, visible chest rise ('a gentle wiggle') during PPV for preterm infants. Excessive chest rise indicates high tidal volumes that risk volutrauma and BPD.

Which of the following methods can help prevent cold stress in a preterm infant less than 32 weeks in the delivery room?

Answer: Polyethylene wrap, prewarmed delivery room (25–26°C), prewarmed radiant warmer, and chemical warming mattress

A bundle of interventions is recommended: polyethylene wrap/bag (without drying), prewarmed radiant warmer, room temperature ≥25–26°C, and a chemical warming mattress for the most premature infants.

At what gestational age is a preterm infant considered to have adequate thermal regulation without a polyethylene wrap?

Answer: 32–36 weeks

NRP specifically recommends polyethylene wrap for infants less than 32 weeks. Infants 32–36 weeks have better thermoregulation and can be managed with standard drying and warm blankets, though individual assessment is needed.

What is the NRP recommendation regarding oxygen use at the start of resuscitation for infants less than 35 weeks gestation?

Answer: Start with 21–30% oxygen and titrate to NRP SpO2 targets

For preterm infants less than 35 weeks, NRP recommends initiating resuscitation with 21–30% oxygen, using pulse oximetry to titrate FiO2 to age-appropriate SpO2 targets.