Post-Resuscitation Care and Stabilization
The infant is not finished when the heart rate is normal
After any resuscitation, the infant needs a monitored environment - usually the NICU - with continuous heart rate, respiratory, and oxygen saturation monitoring, and ideally blood pressure surveillance. Titrate oxygen to preductal SpO2 targets (approximately 88–95% once stabilized, avoiding hyperoxia), manage ventilation gently, and check a blood glucose because both hypoglycemia and hyperglycemia worsen outcome.
Temperature is therapy
Keep the temperature in the normal range. For infants ≥36 weeks' gestation with evolving moderate-to-severe hypoxic-ischemic encephalopathy, therapeutic hypothermia started within about 6 hours improves outcomes; for smaller infants, prevent hyperthermia and follow local protocols. Avoid overheating during transport and during the initial resuscitation of the preterm infant too - but do not let prevention of hyperthermia become hypothermia.
Communication and review
Explain findings to the family in plain language, document interventions and timing, consider cord blood gases and placental pathology, and conduct a team debrief while memories are fresh. Debriefing is the highest-yield quality-improvement tool available.
Traps
Stopping at a normal heart rate and skipping glucose or temperature checks; targeting 100% saturation in a depressed infant; assuming a vigorous-appearing infant needs no further observation; forgetting to hand over the resuscitation timeline.
Rule of thumb
Every resuscitated infant earns a glucose, a temperature plan, and a debrief. Worked example: a term infant with HR 50 at birth now 130/min - admit, monitor, check glucose, keep normothermic, and screen neurologically for encephalopathy.