{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T14:10:07Z","timestamp":1780063807062,"version":"3.54.0"},"reference-count":19,"publisher":"Springer Science and Business Media LLC","issue":"5","license":[{"start":{"date-parts":[[2025,10,7]],"date-time":"2025-10-07T00:00:00Z","timestamp":1759795200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,10,7]],"date-time":"2025-10-07T00:00:00Z","timestamp":1759795200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Pediatr Res"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The International Liaison Committee on Resuscitation recommends initiating chest compressions (CC) in newborns when heart rate (HR) is &lt;60 beats per minute (bpm) after 30\u2009s of effective positive pressure ventilation (PPV).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Near-term lambs with asphyxia induced bradycardia (HR\u2009&lt;\u200960\u2009bpm) were randomized to: (i) control (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20096)\u2014 Resuscitation per current Neonatal Resuscitation Program (NRP) (ii) study (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20096)\u2014PPV continued until HR\u2009=\u20090, only then CC with PPV were administered in a ratio of 3:1 until return of spontaneous circulation (ROSC). Outcomes included timing, incidence of ROSC, CC requirement, blood gases, and peak coronary, carotid, and pulmonary blood flow.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The time to achieve ROSC was not different between groups (3\u2009\u00b1\u20092\u2009min vs. 1.6\u2009\u00b1\u20091\u2009min in study (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.17). Only 1\/6 lambs in study group required CC versus 6\/6 in control group (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.015). At ROSC, the study group had significantly lower arterial PaCO2 (47\u2009\u00b1\u20095\u2009mmHg vs. 94\u2009\u00b1\u200918\u2009mmHg,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.01) and higher arterial PaO\n                      <jats:sub>2<\/jats:sub>\n                      (148\u2009\u00b1\u200953\u2009mmHg vs. 54\u2009\u00b1\u200912\u2009mmHg,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.01). The asynchronous external CC in the control group contributed to the loss of inherent cardiac activity.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Prioritizing ventilation during bradycardia reduced need for CC, facilitated faster ROSC, and improved gas exchange in an ovine model.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Impact<\/jats:title>\n                    <jats:p>\n                      <jats:list list-type=\"bullet\">\n                        <jats:list-item>\n                          <jats:p>Prioritizing ventilation over chest compressions beyond 30\u2009s for bradycardia during neonatal resuscitation improves outcomes, reducing the need for chest compressions and accelerating the time to return of spontaneous circulation.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>Pulseless electrical activity occurs before complete cardiac arrest.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>Focusing on initiating chest compressions at a specific heart rate will distract providers from prioritizing ventilation.<\/jats:p>\n                        <\/jats:list-item>\n                      <\/jats:list>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1038\/s41390-025-04444-9","type":"journal-article","created":{"date-parts":[[2025,10,7]],"date-time":"2025-10-07T15:19:38Z","timestamp":1759850378000},"page":"1992-1998","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Neonatal resuscitation for bradycardia (HR\u2009&lt;\u200960\u2009bpm)\u2014an alternate approach using an ovine model"],"prefix":"10.1038","volume":"99","author":[{"given":"Mausma","family":"Bawa","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sylvia","family":"Gugino","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Justin","family":"Helman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole","family":"Bradley","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lori","family":"Nielsen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arun","family":"Prasath","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clariss","family":"Blanco","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Munmun","family":"Rawat","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Praveen","family":"Chandrasekharan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,10,7]]},"reference":[{"key":"4444_CR1","doi-asserted-by":"crossref","unstructured":"Weiner, G. 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