The SURV1VE-Trial is improving knowledge of how to administer chest compressions during resuscitation of newborn babies.
When newborn babies are born with a low heart beat or without a heart beat, the clinical team must provide breathing and chest compressions (what we call cardiopulmonary resuscitation) to the newborn baby. Chest compressions are an infrequent event in newborn infants, and outcome studies of delivery room resuscitations have reported high rates of mortality and neurodevelopmental impairment in those infants receiving chest compressions. The poor prognosis associated with receiving chest compressions in the delivery room raises questions as to whether improved cardiopulmonary resuscitation methods specifically tailored to the newborn could improve outcomes.
Currently we use a 3:1 ratio, which equals 3 chest compressions to one rescue breath to resuscitate a newborn baby. This means that we stop chest compressions after every 3rd compression to give one rescue breath. We believe that this interruption of chest compressions is bad for the newborn baby and that chest compressions should be continued without interruption while rescue breaths are given continuously. We believe that this approach will allow us to reduce death and long-term burdens in newborn babies born without a heartbeat.
This will be a multi-centre clinical trial, which will be performed at several sites across Canada, the USA, Europe, Australia, China, and Qatar. In the delivery room of participating centers, babies who are born with a low heart beat or without heart beat will be randomized to two different chest compression techniques to assess which technique improves their care. At the delivery room of all participating sites, newborn infants (preterm and term infants) will be randomized to receive either the 3:1 ratio (standard care) or our novel developed chest compression technique.
We expect that our approach represents a unique way of delivering chest compression and rescue breaths for newborn infants. This approach will allow us to reduce death and long-term burdens in newborn babies born without a heartbeat. This is a unique approach, which has the potential to improve the care of many newborn babies in Canada and around the world.