The association of duration of FMV and mortality may be related
to several factors. First, some babies may have been in secondary
apnea and depending on the extent of circulatory collapse unlikely
to respond to stimulation, suction, and ventilation only. We have
reported separately that many of the infants in need of resuscitation
presented with obstetrical complications and fetal heart rate
abnormalities.19 Moreover, no infant received chest compressions,
medications, or mechanical ventilation. It is unclear whether these
interventions would have reduced mortality. Second, application
and administration of FMV may have been suboptimal. Thus in a
non breathing infant establishment of functional residual capacity,
which is critical to effective ventilation, can be extremely difficult
without the application of continuous positive airway pressure or
prolonging the inspiratory time which are both difficult to achieve
with a self inflating bag.
The association of duration of FMV and mortality may be relatedto several factors. First, some babies may have been in secondaryapnea and depending on the extent of circulatory collapse unlikelyto respond to stimulation, suction, and ventilation only. We havereported separately that many of the infants in need of resuscitationpresented with obstetrical complications and fetal heart rateabnormalities.19 Moreover, no infant received chest compressions,medications, or mechanical ventilation. It is unclear whether theseinterventions would have reduced mortality. Second, applicationand administration of FMV may have been suboptimal. Thus in anon breathing infant establishment of functional residual capacity,which is critical to effective ventilation, can be extremely difficultwithout the application of continuous positive airway pressure orprolonging the inspiratory time which are both difficult to achievewith a self inflating bag.
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