NRP Preterm Infant Resuscitation

Question 1

What is the most important intervention for preventing heat loss in a preterm infant less than 32 weeks gestation in the delivery room?

Accepted Answer

Placing the infant in a polyethylene plastic wrap or bag without drying

Answer

For preterm infants less than 32 weeks, NRP recommends placing the infant immediately (without drying) into a polyethylene wrap or bag under a radiant warmer to minimize evaporative and conductive heat loss.

Question 2

What initial PEEP (positive end-expiratory pressure) is recommended when providing positive-pressure ventilation to a preterm infant?

Accepted Answer

5 cmH2O

Answer

NRP recommends providing PEEP of 5 cmH2O during PPV for preterm infants to maintain alveolar recruitment and functional residual capacity, given their surfactant deficiency and tendency for atelectasis.

Question 3

When should surfactant therapy be considered for a preterm infant during delivery room management?

Accepted Answer

For intubated preterm infants with respiratory distress syndrome who require ventilatory support

Answer

Surfactant is indicated for preterm infants with respiratory distress syndrome (RDS) who require intubation and mechanical ventilatory support. NRP supports early surfactant via intubation or LISA/MIST for eligible infants.

Question 4

What is the target axillary temperature for a preterm infant in the delivery room according to NRP guidelines?

Accepted Answer

36.5–37.5°C

Answer

NRP recommends maintaining the axillary temperature of preterm infants at 36.5–37.5°C to prevent both hypothermia and hyperthermia, as both are associated with adverse outcomes.

Question 5

Why is a preterm infant at increased risk for intraventricular hemorrhage (IVH) during delivery room resuscitation?

Accepted Answer

Preterm infants have fragile germinal matrix vessels that are vulnerable to fluctuations in cerebral blood flow

Answer

Preterm infants have a highly vascularized germinal matrix adjacent to the lateral ventricles. These immature vessels lack the structural support and autoregulatory capacity of mature vessels, making them vulnerable to rupture from abrupt changes in cerebral blood flow and pressure.

NRP - Neonatal Resuscitation Program Practice Test

NRP - Neonatal Resuscitation Program Practice Test

NRP Preterm Infant Resuscitation