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Suction (mechanical) Pressure relief valve Straight blades (#0 and #1) Warmer M.E.J. ANESTH 20 (1), 2009 NEONATAL RESUSCITATION and there is right to left shunting of blood across the foramen ovale and ductus arteriosus umbilical cord significantly increases systemic vascular resistance and contributes to a functional closure of the foramen ovale within the first few minutes of birth. A left to right reversal of the shunt across the ductus arteriosus results.. Because it takes days to weeks for the ductus arteriosus to anatomically close, there may be a right to left reversal of the shunt anytime pulmonary vascular resistance rises above systemic. Several states can predispose the infant to this reversal during this “transitional phase” . Conditions such as meconium aspirations can result in a more persistent Table 2 The �ve criteria of the APGAR score Table 3 Biophysical Pro�le Tests and Criteria Biophysical Profile Test M.E.J. ANESTH 20 (1), 2009 NEONATAL RESUSCITATION M.E.J. ANESTH 20 (1), 2009 NEONATAL RESUSCITATION Provide warmth Thermoregulation is a critical component of the initial resuscitative effort. This can be accomplished by simply placing the neonate under a radiant warmer. The infant should be uncovered to allow for full visualization and adequate heat transference. Thermoregulation is particularly important in very low M.E.J. ANESTH 20 (1), 2009 NEONATAL RESUSCITATION rate, chest wall movement should be assessed, the head and facemask should be repositioned, airway cleared and suctioned. After several failed attempts at assisted Initial ventilation strategies in preterm Tube size (mm) Weight (g) Adapted from AAP/ AHA Neonatal Resuscitation. Chest Compression Ventilation is vital to resuscitation efforts. Since, M.E.J. ANESTH 20 (1), 2009 NEONATAL RESUSCITATION an infant born to an opioid addicted mother because it