Evidence-based Guidelines Process

In 1998 the NRP Steering Committee of the American Academy of Pediatrics and the Pediatric Subcommittee of the American Heart Association began working together to review the pediatric resuscitation scientific literature. Committee members and colleagues evaluated the quality of evidence that exists to support current neonatal resuscitation practices and to suggest changes in them. This process involved the critical review of hundreds of published articles relating to all aspects of neonatal resuscitation, from the initial step of providing the proper thermal environment to advanced interventions, such as epinephrine administration and volume expansion.

Members of the committee were assigned specific topics to review. Once reviewers identified the most critical research in their topic area, they prepared comprehensive worksheets that rated and weighted the strength of published studies and determined the class of recommendation to support the existing or proposed guidelines.

Since that time guidelines proposals were debated in September 1999 at the Evidence Evaluation (E2) Conference in Dallas, TX. At that conference, individuals who prepared worksheets, content experts, and invited guests participated in a number of topic specific panels to discuss and debate the level of evidence and class recommendations for proposed guidelines. The first consensus on science and guidelines were released in 2000, with an update in late 2005.

In February 2010, more than 40 neonatologists and neonatal health care professionals from 14 countries convened in Dallas, TX for an intensive, five-day meeting of the International Liaison Committee on Resuscitation (ILCOR) Neonatal Delegation to critically analyze the new scientific data published since the 2005 guidelines and determine new international resuscitation recommendations.

The ILCOR Neonatal Delegation was comprised of representatives from the following groups:

  • Australian Resuscitation Council (ARC)
  • Council of Latin America for Resuscitation (CLAR)
  • European Resuscitation Council (ERC)
  • Heart and Stroke Foundation of Canada (HSFC)/Canadian Paediatric Society (CPS)
  • Pediatric Society/Resuscitation Council of Asia (RCA)
  • New Zealand Resuscitation Council (NZRC)
  • Resuscitation Council of South Africa (RCSA)
  • World Health Organization (WHO)
  • American Academy of Pediatrics/American Heart Association NRP Steering Committee

The result of this meeting was the development of the 2010 ILCOR Consensus on Science and Treatment Recommendations and the 2010 AHA/AAP Guidelines for Neonatal Resuscitation published on October 18, 2010 in Circulation.