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Children
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Advances in Neonatal Resuscitation and Intensive Care
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Advances in Neonatal Resuscitation and Intensive Care

A special issue of Children (ISSN 2227-9067). This special issue belongs to the section "Pediatric Emergency Medicine & Intensive Care Medicine".

Deadline for manuscript submissions: 5 October 2025 | Viewed by 3314

Special Issue Editors

Dr. Pranav Jani

E-Mail Website
Guest Editor
1. Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
2. Department of Neonatology, Westmead Hospital, Westmead, NSW 2145, Australia
Interests: golden-hour practices for preterm infants; preventing brain injury; skin care; thermoregulation; incubator humidity
Dr. Dharmesh Shah

E-Mail Website
Guest Editor
Department of Neonatology, Westmead Hospital, Westmead, NSW 2145, Australia
Interests: neonatal resuscitation; echocardiography; extremely preterm infants
Dr. Rajesh Maheshwari

E-Mail Website
Guest Editor
Department of Neonatology, Westmead Hospital, Westmead, NSW 2145, Australia
Interests: infant development; preterm infants; infant nutrition

Special Issue Information

Dear Colleagues,

Neonatal resuscitation and intensive care are essential for preventing neonatal death and adverse long-term neurodevelopmental impairments. Approximately 85% of full-term neonates initiate spontaneous respirations; <10% require advanced resuscitation measures such as positive-pressure ventilation, intubation and chest compression with or without adrenaline to initiate and support breathing and transition to the extrauterine life. Over the past decades, significant advances in all aspects of neonatal care have led to the improved survival of nonates, especially those born before 28 weeks gestation. There has also been a paradigm shift toward providing active care to neonates born at or below 23 weeks gestation. However, inspite of these advances, clinicians face many challenges when caring for unwell neonates right from resuscitation to hospital admission and follow-up care after discharge.

This Special Issue aims to describe the current advances in research on neonatal resuscitation and intensive care for preterm and full-term neonates. We are inviting research from various backgrounds such as animal studies, bench studies and human research that can contribute to advancing knowledge and/clinical care around neonatal resuscitation and intensive care.

Dr. Pranav Jani
Dr. Dharmesh Shah
Dr. Rajesh Maheshwari
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Children is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2400 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • neonatal intensive care
  • resuscitation
  • infant
  • premature infant
  • low-birth-weight infant

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Published Papers (3 papers)

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Research

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15 pages, 1297 KiB  
Article
Evaluating Novel Chest Compression Technique in Infant CPR: Enhancing Efficacy and Reducing Rescuer Fatigue in Single-Rescuer Scenarios
by Marek Solecki, Monika Tomaszewska, Michal Pruc, Magdalena Myga-Nowak, Wojciech Wieczorek, Burak Katipoglu, Basar Cander and Lukasz Szarpak
Children 2025, 12(3), 346; https://doi.org/10.3390/children12030346 - 10 Mar 2025
Cited by 1 | Viewed by 707
Abstract
Background/Objectives: Effective infant cardiopulmonary resuscitation (CPR) relies on high-quality chest compressions, yet the optimal technique for single-rescuer scenarios remains debated. Although widely used, the two-finger technique (TFT) is associated with an inadequate compression depth and increased rescuer fatigue. While the two-thumb encircling [...] Read more.
Background/Objectives: Effective infant cardiopulmonary resuscitation (CPR) relies on high-quality chest compressions, yet the optimal technique for single-rescuer scenarios remains debated. Although widely used, the two-finger technique (TFT) is associated with an inadequate compression depth and increased rescuer fatigue. While the two-thumb encircling hands technique (TTHT) provides a superior compression depth, its application in single-rescuer scenarios is impractical. This study evaluates a novel technique (nT) as a potential alternative, aiming to optimize both compression efficacy and rescuer endurance. Methods: This randomized crossover study assessed the efficacy of the TFT, TTHT, and nT in a simulated infant CPR setting. Medical students trained in newborn and infant resuscitation performed all three techniques in a controlled environment using a high-fidelity neonatal simulator. We objectively measured and compared key CPR performance metrics, rescuer fatigue, and hand pain among the techniques. Results: The nT and TTHT outperformed the TFT in compression depth, rescuer endurance, and overall CPR quality. The nT achieved the highest adequate compression rate (92.4% vs. 78.6% for TTHT and 65.2% for TFT) while minimizing fatigue (RPE: 3.1 vs. 4.5 for TTHT and 6.2 for TFT) and hand pain (NRS: 1.8 vs. 3.9 for TTHT and 5.4 for TFT). TTHT produced the deepest compressions (mean: 44.2 mm vs. 42.9 mm for nT and 38.6 mm for TFT, p < 0.001). Rescuer anthropometric factors (sex, weight, and height) affected all techniques similarly, suggesting no inherent advantage based on body characteristics. Conclusions: Both the nT and TTHT outperformed the TFT, with the nT demonstrating superior rescuer endurance while maintaining high-quality compressions. Given its ergonomic benefits and effectiveness, the nT emerges as a promising alternative for single-rescuer infant CPR and warrants consideration for future resuscitation guidelines. Full article
(This article belongs to the Special Issue Advances in Neonatal Resuscitation and Intensive Care)
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13 pages, 191 KiB  
Article
The Experience of Caring for a Medically Complex Child in the Neonatal Intensive Care Unit: A Qualitative Study of Parental Impact
by Natascia Bertoncelli, Martina Buttera, Elisa Nieddu, Alberto Berardi and Licia Lugli
Children 2025, 12(2), 123; https://doi.org/10.3390/children12020123 - 23 Jan 2025
Viewed by 830
Abstract
Background: Parents of children with life-limiting or life-threatening illnesses and/or medical complexity experience intense stress and pain soon after the birth and lifelong. Understanding parents’ experiences and coping strategies is the prerequisite to provide tailored support to families. Aim: To explore the experiences [...] Read more.
Background: Parents of children with life-limiting or life-threatening illnesses and/or medical complexity experience intense stress and pain soon after the birth and lifelong. Understanding parents’ experiences and coping strategies is the prerequisite to provide tailored support to families. Aim: To explore the experiences of parents of children with medical complexity (CMCs) during hospitalization in a Family-Centered Care (FCC) neonatal unit and after discharge. Design: Qualitative study. Methods: Semi-structured interviews were administered to the parents of children with medical complexity admitted to the Neonatal Intensive Care Unit (NICU) of Modena between October 2016 and January 2024. The interview was developed based on three time points: birth, hospitalization, and discharge, focusing on parents’ experiences, emotions, and communication with healthcare professionals. The interviews were analyzed using the template analysis. Results: A total of 10 parents were interviewed. Four domains were identified, encompassing eight significant themes in the parents’ experiences and their communication with healthcare professionals. The relevant emotions included anxiety and fear for survival, fatigue, and guilt over the child’s suffering, alongside hope and trust that parents felt entitled to nurture. Relationships with professionals were characterized by expectations and frustrations; mothers and fathers had different perceptions and reactions to the situation they were facing. Conclusions: This qualitative study explores the experiences of parents of CMCs in a neonatal intensive care unit adopting FCC. From admission to discharge, parents’ emotions were influenced by the child’s unique clinical history. Active listening and the humane attitude of healthcare professionals were the aspects most appreciated by parents. Full article
(This article belongs to the Special Issue Advances in Neonatal Resuscitation and Intensive Care)

Other

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13 pages, 1933 KiB  
Systematic Review
Chest Compression Superimposed with Sustained Inflation or 3:1 Compression/Ventilation Ratio During Neonatal Cardiopulmonary Resuscitation in the Delivery Room: A Systematic Review and Meta-Analysis
by Jenny Koo, Anup C. Katheria, Brenda Law, Anne Lee Solevåg, Gerhard Pichler and Georg M. Schmölzer
Children 2025, 12(2), 230; https://doi.org/10.3390/children12020230 - 13 Feb 2025
Viewed by 1282
Abstract
Background: Current resuscitation guidelines recommend a 3:1 chest compression/ventilation (C:V) ratio, which is associated with high morbidity and mortality. An alternative might be continuous chest compression superimposed with high distending pressure or sustained inflation (CC + SI). Objective: To compare CC + SI [...] Read more.
Background: Current resuscitation guidelines recommend a 3:1 chest compression/ventilation (C:V) ratio, which is associated with high morbidity and mortality. An alternative might be continuous chest compression superimposed with high distending pressure or sustained inflation (CC + SI). Objective: To compare CC + SI with 3:1 C:V during neonatal cardiopulmonary resuscitation (CPR). Methods: MEDLINE (through PubMed), Google Scholar, EMBASE, and Clinical Trials.gov through June 2024. Randomized controlled trials comparing CC + SI with 3:1 C:V during neonatal CPR in the delivery room were included. Data Analysis included Risk of bias was assessed using the Covidence collaboration tool, and results were pooled into a meta-analysis using a fixed effects model. Main outcomes were In-hospital mortality (primary). Time to return of spontaneous circulation (ROSC) and air leak (secondary). Results: Two studies were included. The pooled data suggests no difference in infant mortality between CC + SI versus 3:1 C:V during neonatal CPR (RR 0.64, 95% CI 0.21,1.7, p = 0.33, I2 = 63%). The use of CC + SI during neonatal CPR could result in 182 fewer per 1000 (from 351 fewer to 311 more) infant deaths. The pooled data suggested a significant reduction in time to ROSC with CC + SI versus 3:1 C:V during neonatal CPR (mean difference 115 s (from 184.75 to 45.36 s), p = 0.001, I2 = 26%). Air leak was not different between groups. Conclusions: While in-hospital mortality and air leak were not different between groups, time to ROSC was significantly reduced. A large clinical trial is warranted to assess if CC + SI improves outcomes. Full article
(This article belongs to the Special Issue Advances in Neonatal Resuscitation and Intensive Care)
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