Neonatal resuscitation in the NICU; Challenges beyond NRP

Resuscitation of neonates in the newborn period requires attention to cardiopulmonary health with a focus on ventilation and return of spontaneous circulation. Newborn resuscitation at delivery is performed according to the Neonatal Resuscitation Program (NRP) algorithm. Infants and children are resuscitated by Pediatric Advanced Life Support (PALS) guidelines from The American Heart Association (AHA). Resuscitation of infants beyond the 24 hours of age represents a challenge in selecting the most suitable algorithm. In general, both the AHA and NRP recommend using NRP guidelines during the immediate newborn period and through their initial hospitalization. However, questions remain whether all aspects of NRP are appropriate for infants who have long hospitalization times, well beyond the transition period, especially preterm infants.