Initial vascular access for neonatal resuscitation: a systematic review.
Mandira D Kawakami, Juin Yee Kong, Maria Fernanda de Almeida et al.
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From the abstract
Establishing vascular access during advanced neonatal resuscitation or cardiac arrest can be difficult but critical for survival and other outcomes. Evidence is needed to support the choice between the available methods of vascular access.
Reported results
No studies directly compared vascular access methods for the outcomes of time to heart rate >100 bpm, time to successful placement of devices, successful vascular access at first attempt or number of attempts. Most complications were reported with use of intraosseous (IO) devices. Umbilical vein catheters (UVC) were used primarily after hospital birth while IO devices were used in a wider range of settings.
Authors' conclusions
Very low certainty evidence indicates that emergency UVC and IO access are feasible during neonatal resuscitation, but limited evidence on effectiveness, timeliness, and safety highlights the need for additional research.
Stated limitations
The lack of RCTs, small sample size and heterogeneity of the studies exclusively from high resource settings limit the generalizability of the results.