Jump to content


Want to join the discussions?

Sign up for a free membership! 

If you are a member already, log in!

(lost your password? reset it here)

99nicu.org 99nicu.org

Physiological-based cord clamping (PBCC) in preterm infants. Experiences of resusc with intact cord?

Recommended Posts

While preparing a lecture on the normal transition from intra- to extrauterine life, I also choosed to include a slide on cord-clamping, and the timing of it.

As the umbilical vein blood contributes significantly to the systemic cardiac output  (through shunting of umbilical vein blood through foramen ovale), there is a physiological reason to clamp/cut the cord once breathing is initiated.

While reading up on some details, I came across a feasibilty study on a resuscitation table intended for preterm infant: https://fn.bmj.com/content/early/2018/10/03/archdischild-2018-315483

Just recently - this research group also published that this approach of physiological-based cord clamping (PBCC) do increase cardiac output and cerebral oxygenation. Proxy outcomes, but still shows that the concept seems right: https://fn.bmj.com/content/103/6/F530

Just curious to hear: does anyone have experience from stabilization with intact cord (preterm or term)?

Update: also found this review by the same research group: https://fn.bmj.com/content/103/5/F493, also published in ADC FN.

  • Like 1
  • Thanks 1
Link to post
Share on other sites
  • 10 months later...

In Linköping we have developed a structure on how to do this in deliveryroom on ELBW less than GW28. It works pretty well if you manage to deal well with the logistic. Receive on the foot-end of deliverybed between the legs of the mother, put the baby in a nest covered by plastic, using a mobile Neopuff with humidified warm gas, Starting with CPAP only awaiting the respond of heartrate and spontaneous breathing, ventilating only if bradycardia, delayed cordclamping. Incubator Close to the bed, connected to mobile CPAP/Ventilator. If intubation immediate Surfactant instillation. We have planned to enhance it into all Babies less than GW32 (33?). Working on a video on it.

Apart from a mobile neopuff, an incubator in Place and a mobile CPAP/ventilator you don´t need any extra equippment. But a well trained team and clear logistic is crucial  (protocol).


  • Like 4
Link to post
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now
  • Create New...