Recent discussions
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Ken Tegtmeyer
i agree with these recommendations based on the studies available. It may be most fruitful to look at provider fatigue, particularly in the out of hospital setting where number of providers to do cpr are likely lowest. Such as single person rescuer at home awaiting for EMS.
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Jogender Kumar
I agree with the recommendations. The recent IPD definitely helps in improving the certainty of the evidence. The group may consider guidance on how to implement it.
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Jogender Kumar
This is one of the most contentious issue in LMIC especially after HELIX trial. There are few points which need further clarifications:
- As per subgroup analysis Servo-controlled devices seems to be inferior to the non-servo controlled devices. Which does not make any sense to me. Rather one would expect the results other ways around. The reader should not take a message that non-servo-controlled methods are better and start adopting them.
- There is need to clearly define the cooling criteria . The major problem is not with technique, but is with selection of the eligible infants. It will be beneficial if the same can be added in practice points.
- Feeding during therapeutic hypothermia is another aspect which requires guidance. I am not sure whether this comes under preview of this group or not but it requires clear guidance.
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Keiji Suzuki
I basically agree the reccommendation.
However, considering the contents that A, B, C, D, and E are dealing with, they had better be re-odered A, D, B, C, and E for easier understanding.
A: no resuscitation required D: resuscitation required
B: not less than 28 weeks C: less than 28 weeks
E: some pathologic conditions
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Renata de Araujo Monteiro Yoshida
I agree
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Renata de Araujo Monteiro Yoshida
I agree. There are a lot of knowledge gaps and opportunity for research on this topic.
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Louise Owen
I understand that the evidence directs us to potentially different treatments in different groups of newborns, that may be confusing for clinicians. How this is worded will be critical. To state that 60s of DCC is recommended for ALL preterm infants is clear, and then add a caveat to say that when this is not possible to consider UCM only for those >28w might reduce the number of msgs.
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Renata de Araujo Monteiro Yoshida
I agree that we should try to offer the best treatment for each gestational age, but I worry about the formation of a group as large and heterogeneous as the 28-36 week group.
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Виктория Антонова
I appreciate the intentionality of the researchers involved to address this glaring question that has largely been unaddressed. The research questions they seek answers to as well as the willingness to update their search four times in the process of analyzing while preparing the recommendations highlights there awareness of the newness and potential implications of these research questions. Based on the data provided, it appears that each of the recommendations is consistent with and directly tied to the outcomes as demonstrated. Thank you for your effort. -
Karina Andrade
I totally agree, too