• Resuscitation · Oct 2021

    Review

    A COMPARATIVE EVALUATION AND APPRAISAL OF 2020 AMERICAN HEART ASSOCIATION AND 2021 EUROPEAN RESUSCITATION COUNCIL NEONATAL RESUSCITATION GUIDELINES.

    • Vadakkencherry RamaswamyViraraghavanVDepartment of Neonatology, Ankura Hospital for Women and Children, Hyderabad, India., Thangaraj Abiramalatha, Gary M Weiner, and Daniele Trevisanuto.
    • Department of Neonatology, Ankura Hospital for Women and Children, Hyderabad, India.
    • Resuscitation. 2021 Oct 1; 167: 151-159.

    AimThe International Liaison Committee on Resuscitation (ILCOR) 2020 Consensus on Science and Treatment Recommendations (CoSTR) for Neonatal Life Support forms the basis for guidelines developed by regional councils such as the American Heart Association (AHA) and the European Resuscitation Council (ERC). We aimed to determine if the updated guidelines are congruent, identify the source of variation, and score their quality.MethodsWe compared the approach to developing recommendations, final recommendations, and cited evidence in the AHA 2020 and ERC 2021 neonatal resuscitation guidelines. Two investigators scored guideline quality using the Appraisal of Guidelines for Research and Evaluation II (AGREE II) tool.ResultsDifferences in the recommendations were found between AHA 2020 and ERC 2021 neonatal resuscitation guidelines. The councils gave differing recommendations for practices that had sparse evidence and made recommendations based on expert consensus or observational studies. AGREE II assessment revealed that AHA scored better for the domain 'rigour of development', but ERC had a higher score for 'stakeholder involvement'. Both AHA and ERC scored relatively less for 'applicability'.ConclusionAHA and ERC guidelines are predominantly based on the ILCOR CoSTR. Differences in recommendations between the two were largely related to the evidence gathering process for questions not reviewed by ILCOR, paucity of evidence for some recommendations based on existing regional practices and supported by expert opinion, and different interpretation or application of same evidence. Overall, both guidelines scored well on the AGREE II assessment, but each had domains that could be improved in future editions.Copyright © 2021 Elsevier B.V. All rights reserved.

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