Survival after Cardiopulmonary Resuscitation in Babies of Very Low Birth Weight

John D. Lantos, Steven H. Miles, Marc D. Silverstein, Carol B. Stocking

Research output: Contribution to journalArticlepeer-review

116 Scopus citations

Abstract

We conducted a retrospective study of outcome after cardiopulmonary resuscitation (CPR) in babies of very low birth weight. Of 158 such babies (birth weight, <1500 g) admitted to a neonatal intensive care unit in 1985, 49 (31 percent) underwent CPR. Low birth weight, low Apgar scores, birth asphyxia, pulmonary interstitial emphysema, hyaline membrane disease, and severe intraventricular hemorrhage were associated with the need for CPR. None of the 38 babies who received CPR in the first three days of life survived. Four of the 11 babies who received CPR after the first 72 hours survived. Three of the four survivors had residual neurologic deficits. Survival rates after CPR in infants of very low birth weight are lower than those in older children or adults. CPR may therefore be considered a nonvalidated therapy in this population. If the results of our study are confirmed, CPR should not be instituted automatically in very-low-birth-weight babies as though it were a validated treatment. Instead, it should be administered upon parents' advance informed consent to experimental treatment. (N Engl J Med 1988; 318:91–5.) BABIES of very low birth weight (<1500 g)1 account for 50 percent of all neonatal deaths, even though they represent only 1.15 percent of all live births in the United States.2 Survival of babies in this weight range has improved dramatically over the past 15 years as a result of advances in neonatal intensive care.3,4 Improvements in survival have been accompanied by questions about the efficacy of neonatal intensive care,5 the limits of viability,6 and the reliability of predictions of prognosis when used to justify the withholding of neonatal intensive care.7 The development of criteria for determining which babies will.

Original languageEnglish (US)
Pages (from-to)91-95
Number of pages5
JournalNew England Journal of Medicine
Volume318
Issue number2
DOIs
StatePublished - Jan 14 1988
Externally publishedYes

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