When should intubation be considered during neonatal resuscitation?

Intubation during neonatal resuscitation should be considered primarily if adequate ventilation is not achieved through other means. In newborns, effective ventilation is critical for ensuring oxygenation and preventing hypoxia. If initial attempts at bag-mask ventilation are unsuccessful, or if the newborn is unable to maintain adequate spontaneous respirations, intubation becomes necessary to secure the airway and deliver effective breaths directly into the lungs.

While apneic newborns may require intubation if they do not respond to other treatments, the key trigger is the inability to achieve proper ventilation. A heart rate below 60 beats per minute can indicate the need for resuscitation efforts, but it is not the sole criterion for intubation without other factors considered, such as ventilation effectiveness. Additionally, waiting until arrival at the hospital before considering intubation can delay necessary intervention if the newborn is in critical condition. Thus, the focus should always be on achieving adequate ventilation, making it the most appropriate reason to proceed with intubation in the context of neonatal resuscitation.