Surveillance of outcome of resuscitated term babies with no heart rate detected at 10 minutes of age starts next month

This study, run through the British Paediatric Surveillance Unit (BPSU), will identify the incidence of term babies who receive resuscitation following birth and have no heart rate detected at 10 minutes of age, describing the demographic characteristics, clinical features and initial management of this population; describe the mortality rate, timing and cause of death for infants who die; and describe the neurodevelopmental outcome at one and two years of age for survivors.

Though the outcome for infants with no heartbeat detected at 10 minutes is considered to be poor, recent studies of small numbers of babies suggest that the outlook may be better than previously thought. If these babies are more representative of what is happening today, then the chances of a good outcome are reasonable and the practice of stopping resuscitation at 10 minutes might be inappropriate. 

These recent studies, however, have limitations. The studies only included babies who survived to admission to the intensive care unit. They did not include babies for whom resuscitation was stopped at 10 minutes or was continued beyond 10 minutes but was unsuccessful. Also, because these babies did unexpectedly well, they may have seemed more important to report. However, they may be exceptional and not a fair reflection of what might be expected for most babies who do not have a heart beat at 10 minutes. 

A large study that includes all babies in a defined area who are resuscitated and who do not have a heartbeat detected at 10 minutes is necessary to best determine the outlook for these babies. Population-based outcome data are required to improve counselling for parents, the quality of care for our babies and to inform the development of evidence based resuscitation guidance.

More about this study