Neonatal Resuscitation Clinical Trial
Official title:
Back Rubs or Foot Flicks for Neonatal Stimulation at Birth in a Low-resource Setting: an Open-label Randomised Superiority Trial
Physical stimulation is the most common intervention during neonatal
stabilization/resuscitation at birth and is recommended by neonatal resuscitation guidelines
in high as well low-income settings. Two modalities of stimulation (back rubs or foot flicks)
are recommended.
This is a single center, unblinded, randomized superiority trial. Immediately after birth,
all "not crying" infants will be randomly assigned in a 1:1 ratio to two different modes of
stimulation (back rubs or foot flicks). Exclusion criteria will be stillbirths and presence
of major neonatal malformations. The primary outcome measure will be the need for FMV.
Secondary outcome measures will include Apgar score at 5 minutes, time of initiation and
duration of FMV, time to first cry (defined as the first audible cry spontaneously emitted by
the infant), death or moderate to severe hypoxic-ischemic encephalopathy within 7 days of
life or at discharge, admission to special care, and procedure-associated complications.
The results of the present study will help to identify the most appropriate mode for
stimulating the apneic newly infants in delivery room. In clinical practice, this information
is very relevant because effective stimulation at birth will elicit spontaneous respiratory
in a certain percentage of apneic neonates avoiding the need for positive pressure
ventilation and, possibly, further advanced resuscitative maneuvers.
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