Preferred method for chest compressions in neonatal resuscitations

In the most of neonatal resuscitations, if adequate ventilation is achieved, no need for chest compressions . However, in certain cases of advanced asphyxia and myocardial depression or severe pulmonary dysfunction in which adequate ventilation cannot be readily achieved, chest compressions are necessary to support the circulation during more extensive resuscitation.

Thus, the indication for chest compressions in the newly born differs significantly from that in older children and adults. The mechanics of the thoracic cage and the physical forces of the circulation of blood also differ, especially in preterm infants. The predominance of pulmonary dysfunction, necessitates a relatively lower ratio of compressions to ventilations. The 3:1 ratio of compressions to ventilations is performed with 90 compressions and 30 interposed breaths per minute (or one cycle of 4 events every 2 seconds).

The preferred method for chest compressions is the two-thumb-encircling-hands method , which provides firm support for the back and generates higher systemic arterial pressure and better coronary perfusion pressure than the two-finger method.