Aim

The 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.

Methods

We 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.

Results

Differences 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’.

Conclusion

AHA 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.

中文翻译：

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2020年美国心脏协会和2021年欧洲复苏委员会新生儿复苏指南的比较评价与评价

目的

国际复苏联络委员会 (ILCOR) 2020 年新生儿生命支持科学和治疗建议 (CoSTR) 共识构成了美国心脏协会 (AHA) 和欧洲复苏委员会 (ERC) 等地区委员会制定的指南的基础。我们旨在确定更新后的指南是否一致，确定变异来源，并对其质量进行评分。

方法

我们比较了 AHA 2020 和 ERC 2021 新生儿复苏指南中制定建议、最终建议和引用证据的方法。两名研究人员使用研究和评估指南评估 II (AGREE II) 工具对指南质量进行评分。

结果

AHA 2020 和 ERC 2021 新生儿复苏指南之间的建议存在差异。委员会对证据稀少的做法提出了不同的建议，并根据专家共识或观察性研究提出建议。AGREE II 评估显示 AHA 在领域“发展的严谨性”方面得分更高，但 ERC 在“利益相关者参与”方面得分更高。AHA 和 ERC 的“适用性”得分相对较低。

结论

AHA 和 ERC 指南主要基于 ILCOR CoSTR。两者之间的建议差异主要与 ILCOR 未审查问题的证据收集过程、基于现有区域实践并得到专家意见支持的某些建议缺乏证据以及对相同证据的不同解释或应用有关。总体而言，这两个指南在 AGREE II 评估中的得分都很高，但每个指南都有可以在未来版本中改进的领域。