Neonatal cardiopulmonary resuscitation: is ROSC enough?

The study by Morin et al. examines a critical question with a profound short and long-term outcome after neonatal code events—what is the most effective way to provide cardiopulmonary resuscitation in this population at risk for short and long-term morbidity and mortality? They studied twenty infantile piglets and randomized to continuous chest compressions superimposed with sustained inflation (CC + SI) versus chest compressions with asynchronized ventilation (CCaV), hypothesizing the addition of SI would reduce time to return of spontaneous circulation (ROSC) following asphyxia-induced bradycardic arrest. CC + SI increased intrathoracic pressure, minute ventilation, and reduced duration of resuscitation compared CCaV in this model. The use of a gyrencephalic model of brain development is a strength of this study; however, numbers are small, and the study does not address long-term outcomes or brain injury post-arrest.