Initial ventilation strategies during newborn resuscitation.

Ventilation alone is usually effective in most neonatal resuscitation episodes. A review of the evidence underpinning recommendations for methods and devices for providing initial ventilation during newborn resuscitation was conducted. Self-inflating bags, flow-inflating (anesthesia) bags, and T-piece devices all may be used to provide effective ventilation after birth, with none clearly superior. Whichever method is used, ventilation is likely to be delivered more consistently if a pressure-monitoring device is incorporated. The best indication of successful ventilation is a prompt increase in heart rate. The role of positive end-expiratory pressure during resuscitation requires further research, particularly in preterm infants, in whom it may protect against lung injury.