When should chest compressions be initiated during newborn resuscitation?

Initiating chest compressions during newborn resuscitation is critical when the heart rate falls below 60 beats per minute, despite adequate ventilation efforts. This heart rate threshold is essential because a heart rate below this level indicates severe bradycardia, which can lead to cardiac arrest if not addressed promptly.

In the context of newborn resuscitation, adequate ventilation is typically achieved through positive pressure ventilation, which helps to oxygenate the infant's blood and restore a reasonable heart rate. However, if the heart rate does not improve and remains below 60 beats per minute after these ventilation attempts, chest compressions are necessary to manually pump blood and restore circulation, thereby improving oxygen delivery to vital organs.

Initiating compressions at this stage is crucial for increasing intrathoracic pressure, facilitating blood flow, and ultimately supporting any remaining cardiac function. It is important for caregivers to recognize this specific threshold to act quickly in facilitating the newborn's recovery during resuscitation efforts.