The Use of Biochemical Markers in Newborns

I n contrast to other critical care settings, management of the newborn at delivery is unique in that neonatologists witness the genesis of disease. Neonatology includes the requirement to resuscitate the newborn infant at the time of delivery, and for many infants, this critical transition from intrauterine to extrauterine life is hazardous because of maternal preexisting conditions, fetal abnormalities, anatomical or functional placental abnormalities, and the combination of any of these problems. This transition from fetal to neonatal conditions is often abrupt, with respiratory, cardiac, and metabolic perturbations that are physiologically challenging, particularly for the premature newborn. It is increasingly recognized that the early management of cardiopulmonary failure in the newborn is not only lifesaving, but can potentially be injurious with long-term implications. Indeed, the notion of the “golden hour” in trauma management might be analogous to the “golden 10 mins” in neonatal resuscitation. Delivery Room Resuscitation