Newborn or Pediatric resuscitation algorithm in infants: A scoping review protocol

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Objective: The objective of this scoping review is to summarize the evidence pertaining to the: 1) Use 2) Outcomes, and 3) Educational implementation of Pediatric Life Support (PLS) and/or Neonatal Life Support (NLS) algorithms in neonates (after birth until 28 days of life) and infants (after 28 days until 12 months of life). Introduction: The varied use of NLS and/or PLS algorithms in neonates and infants results in differences in clinical practice and might influence clinical outcomes, including survival from bradycardia or cardiac arrest. Consequently, the question of when to use the NLS or PLS algorithms was prioritized by the International Liaison Committee in Resuscitation (ILCOR) Neonatal Life Support (NLS) Task Force, and the Pediatric Life Support (PLS) and Education, Implementation and Teams (EIT) Task Forces were invited to contribute to a nodal review. Acknowledging that a scoping review cannot answer the question of which algorithm is better under different circumstances, the task forces intend to perform systematic reviews provided that sufficient evidence has been identified after having scoped the literature. Inclusion criteria: The scoping review will include neonates and infants who require cardiopulmonary resuscitation for any reason at any time after the immediate newborn period up until a year of age (Participants) in the neonatal intensive care unit, pediatric intensive care unit, pediatric cardiac intensive care unit, pediatric ward, emergency department, postnatal ward or locations outside the hospital (e.g., emergency medical system response) with the use of NLS or PLS algorithms and strategies for cardiopulmonary resuscitation resuscitation events (Concept). Practitioners managing these infants want direction on which algorithm to use (Context). Outcomes: The age, pathophysiology, patient characteristics, Utstein variables {Nolan, 2019 #3091}{Foglia, 2023 #3092}, location, provider and any clinical outcomes. Exclusion criteria: Newborn infants within 24 hours of birth, trauma, burns, drowning, advanced care plan that limits resuscitation, and lay responders. Methods: Key information sources to be searched are Ovid MEDLINE, CINAHL, Embase, Cochrane Central Register of Controlled Trials and Cochrane Database of Systematic Reviews and clinical trial registries from their inception until the final search date. No limits regarding language will be applied if there is an English abstract. Following the search, all identified citations will be uploaded into Covidence and duplicates removed. Titles and abstracts will then be screened by two or more independent reviewers for assessment against the inclusion criteria for the review. Potentially relevant sources will be retrieved in full. The full text of selected citations will be assessed in detail against the inclusion criteria by two or more independent reviewers. Reasons for exclusion of sources of evidence in full text that do not meet the inclusion criteria will be recorded and reported in the scoping review. Any disagreements that arise between the reviewers at each stage of the selection process will be resolved through discussion, or with an additional reviewer. The results of the search and the study inclusion process will be reported in full in the final scoping review and presented in a PRISMA flow diagram. Data will be extracted from papers included in the scoping review by two or more independent reviewers using a data extraction tool developed by the reviewers. The data extracted will include specific details about the participants, concept, context, study methods and key findings relevant to the review question/s. The number and type of included evidence as well as study characteristics will be reported and a conclusion based on an interpretation of the review findings in line with the review’s objective/s and any limitations of the review will be provided.

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