Lalana Newborn Resuscitation

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Lalana Newborn Resuscitation

Journal Title: Journal of Clinical Medical Research - Year 2021, Vol 2, Issue 3

Abstract

Background: Birth asphyxia is a leading cause of perinatal and neonatal morbidity and mortality with intrapartum factors rather than antepartum or post-partum having a major impact, hence effective resuscitation of newborns takes on priority in saving lives. Newly born resuscitation is unique in that displacement of fetal fluid filled lung requires continuous positive pressure ventilation by sustained nasal oxygen inflation as opposed to intermittent positive pressure ventilation to initiate breathing facilitating vital cardio-vascular changes from fetal to adult life. Aim: Quick and safe resuscitation of hypoxic/asphyxiated newborns transiting from fetal fluid filled lungs to well aerated neonatal lungs with onset of rhythmic respiration triggering large reduction in Pulmonary Vascular Resistance (PVR), facilitating a series of cardiovascular changes essential for survival after birth. Method: The study comprised of 1,383 consecutive singleton live births during 14-month period from 1st April 2016 to 31st May 2017, wherein 60% (n=830/1383) deliveries were attended, exclusion criteria 12 twin pregnancies and 10 stillbirths. Resuscitation of hypoxic/asphyxiated newborns involves one to three steps. STEP I: Assessment of score zero to +5 by pulse oximetry based on peripheral oxygen saturation. STEP II: Classification as “Normal” and hypoxic/asphyxiated newborns Graded I-V based on SpO2, pattern of respiration, rate/min and heart rate (bpm). STEP III: Lalana Newborn Resuscitation (LNR) Protocol I and II by sustained nasal oxygen inflation, proven both scientifically and physiologically to initiate rhythmic respiration. Results: Incidence of birth asphyxia was 21.4%, all 178 hypoxic/asphyxiated newly borns Graded I-V within 20-60 seconds of birth, were successfully resuscitated by sustained nasal inflatory, oxygen flow at rate of 4-15 Litres/minute directed to baby’s nostrils through a wide bore tube for up to 1 to 3 minutes, initiating rhythmic breathing, respiratory rate 30-60/min, heart rate 120-160 beats per minute (bpm) and, SpO2>96% monitored continuously by Pulse Oximeter. Conclusion: ‘Lalana Newborn Resuscitation’ (LNR) proved effective in all 178 asphyxiated newborns, Grade I-V by continuous positive pressure ventilation with sustained nasal oxygen inflation at flow rates of 4-15 L/min, commenced rhythmic breathing within 1-3 minutes of birth, successfully resuscitated with respiratory rate 30-60/min, heart rate 120-160 bpm and Zero pulse oximetry score, SpO2 >96%.

Authors and Affiliations

Dr. Grace Lalana Christopher

Keywords

Lalana Newborn Resuscitation (LNR); Continuous Positive Pressure Ventilation (CPPV); Sustained Nasal Oxygen Inflation; Pulse Oximetry Score; SpO2; Grade I to V

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EP ID EP698987
DOI http://dx.doi.org/10.46889/JCMR.2021.2305
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