An Electronic Resuscitator for Possible Use in Asphyxia Neonatorum †

Many methods have been proposed for resuscitation of the newborn but there is as yet no single widely accepted approach to this commonly recurring problem. It is the purpose of this paper to review briefly the electronic methods of resuscitation and to describe animal experiments with a simple electronic apparatus which may be of value for the human newborn. In 1948 Sarnoff et al.' reported animal experiments with a phrenic nerve stimulator. Even after complete cessation of spontaneous respiration following injection of one per cent procaine hydrochloride into the posterior fossa of the brain, the animal could be kept alive with the stimulator. In human experiments using wire stimulating electrodes wrapped around the phrenic nerve, Whittenberger, Sarnoff, et al.9 showed that significantly greater than normal minute volumes were obtained even though sub-maximal stimulation was used. Some patients reported shoulder pain but no permanent nerve damage was found. Cross and Roberts8 in 1950 reported 25 successes in 29 resuscitation attempts using a phrenic nerve stimulator on infants suffering from asphyxia neonatorum. The four failures occurred in a group of nine infants classified by them as severely ill. Knodt5' in 1951 described his experience with an electro-lung designed in 1950 by Hofmann. The electrodes were placed in such a manner as to stimulate alternately the diaphragm (inspiration), and the abdominal muscles (expiration). For inspiration, a belt consisting of two metal electrode strips separated from each other by two strips of insulating material was placed around the thorax at the level of the diaphragm, passing in front of the xyphoid process, so that one electrode was over the anterior chest and one on the back. Stimulation of the anterior thorax caused contraction of