Q: Should very prem babies be given CPR?

So it’s all ethical stuff at the moment. Does the following question reach a point where evidence no longer has a role?

“A premature baby born at 24 weeks gestational age is admitted to the neonatal unit having been born apnoeic, floppy, blue and without a heart rate. After cardio-pulmonary resuscitation (CPR) with adrenaline in the delivery room, a heart rate was noted. Is CPR in these infants inappropriate? What is the chance of survival and risk of disability?

So … if there is one survivor, does this mean we should undertake CPR? If there are currently no survivors – because we don’t often do it, or because we have to think about the past and how it might not have been as good – should we do it anyway? And does survival with a disability or without one matter anyway?

Can evidence help this question at all?

What opinions exist out there – about the evidence, rather than just recitation of guideline statements?

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