2025 Korean Guidelines for Cardiopulmonary Resuscitation: Part 9. Neonatal resuscitation: a secondary publication

The 2025 Korean Guidelines for Cardiopulmonary Resuscitation provide updated, evidence-based recommendations to optimize the transition from intrauterine to extrauterine life. While approximately 85% of term newborns initiate spontaneous breathing independently, timely intervention is critical for those requiring assistance. Key updates in the 2025 guidelines emphasize umbilical cord management, recommending deferred cord clamping for at least 60 seconds in vigorous term and preterm infants (<37 weeks). When deferred cord clamping cannot be performed, intact umbilical cord milking may be reasonable for nonvigorous term and late preterm infants (≥35 weeks’ gestation) and for preterm infants born between 280/7 and 366/7 weeks’ gestation who do not require immediate resuscitation. Respiratory support should be initiated within the “golden minute,” starting with 21% oxygen for term and late preterm infants (≥35 weeks) and ≥30% for those <32 weeks’ gestation. The guidelines introduce video laryngoscopy as a preferred tool for less experienced providers and recognize supraglottic airways as a viable alternative to face masks or when intubation fails. For advanced resuscitation, a compression to ventilation ratio of 3:1 is maintained, with intravascular epinephrine (0.01–0.03 mg/kg) as the primary pharmacologic intervention. Notably, the use of sodium bicarbonate is no longer recommended. Discussions regarding the discontinuation of resuscitation are now suggested at approximately 20 minutes after birth if no response is observed. These guidelines aim to standardize clinical practice in Korea to improve neonatal survival and longterm neurodevelopmental outcomes.

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Journal
Pediatric Emergency Medicine Journal
Published
2026-10-01
DOI
https://doi.org/10.22470/pemj.2026.01753
Primary Topic
Neonatal Respiratory Health Research
Type
article
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article

2025 Korean Guidelines for Cardiopulmonary Resuscitation: Part 9. Neonatal resuscitation: a secondary publication

Mi-Jin Lee, Sung Oh Hwang, Kyoung‐Chul Cha, Ju Sun Heo et al.
Pediatric Emergency Medicine Journal
Neonatal Respiratory Health Research
article

2025 Korean Guidelines for Cardiopulmonary Resuscitation: Part 9. Neonatal resuscitation: a secondary publication

Mi-Jin Lee, Sung Oh Hwang, Kyoung‐Chul Cha, Ju Sun Heo, Ah‐Young Oh, Yong Soo Jang, Sung Phil Chung, Ji Sook Lee, Young Hwa Jung, Ellen Ai‐Rhan Kim, Hyun‐Joo Seol, Chun Song Youn, Youngbin Jang, Gyu Chong Cho, Tae Youn Kim, Gyu Hong Shim, Gi Su Lee, Su Jin Cho, Chang Hee Lee, Do Kyun Kim, Jung Hyun Lee, You Dong Sohn, YunHee Oh, Hye Jin Myung
article en

Abstract

The 2025 Korean Guidelines for Cardiopulmonary Resuscitation provide updated, evidence-based recommendations to optimize the transition from intrauterine to extrauterine life. While approximately 85% of term newborns initiate spontaneous breathing independently, timely intervention is critical for those requiring assistance. Key updates in the 2025 guidelines emphasize umbilical cord management, recommending deferred cord clamping for at least 60 seconds in vigorous term and preterm infants (<37 weeks). When deferred cord clamping cannot be performed, intact umbilical cord milking may be reasonable for nonvigorous term and late preterm infants (≥35 weeks’ gestation) and for preterm infants born between 280/7 and 366/7 weeks’ gestation who do not require immediate resuscitation. Respiratory support should be initiated within the “golden minute,” starting with 21% oxygen for term and late preterm infants (≥35 weeks) and ≥30% for those <32 weeks’ gestation. The guidelines introduce video laryngoscopy as a preferred tool for less experienced providers and recognize supraglottic airways as a viable alternative to face masks or when intubation fails. For advanced resuscitation, a compression to ventilation ratio of 3:1 is maintained, with intravascular epinephrine (0.01–0.03 mg/kg) as the primary pharmacologic intervention. Notably, the use of sodium bicarbonate is no longer recommended. Discussions regarding the discontinuation of resuscitation are now suggested at approximately 20 minutes after birth if no response is observed. These guidelines aim to standardize clinical practice in Korea to improve neonatal survival and longterm neurodevelopmental outcomes.

Pediatric Emergency Medicine JournalVol. 13(4)
Namseoul University (KR), Ewha Womans University (KR), Seoul National University (KR), Hallym University (KR), Inha University (KR), Yonsei University (KR), Asan Medical Center (KR), Seoul National University Hospital (KR), Seoul National University Bundang Hospital (KR), University of Ulsan (KR), The Catholic University of Korea St. Vincent's Hospital (KR), Seoul National University Children's Hospital (KR), Inje University Sanggye Paik Hospital (KR), Ewha Womans University Medical Center (KR), Inha University Hospital (KR), Korea University Guro Hospital (KR), Keimyung University Dongsan Hospital (KR), Keimyung University (KR), Ajou University (KR), Catholic University of Korea (KR)
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Neonatal Respiratory Health Research
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