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

¹서울대학교 의과대학 소아과학교실
²울산대학교 의과대학 서울아산병원 명예교수
³인제대학교 상계백병원 소아청소년과
⁴이화여자대학교 의과대학 소아과학교실
⁵가톨릭대학교 의과대학 성빈센트병원 소아청소년과
⁶고려대학 구로병원 산부인과
⁷계명대학교 동산병원 산부인과
⁸서울대학교 의과대학 분당서울대병원 마취통증의학과
⁹서울대학교병원 신생아중환자실 현장교육전담간호사
¹⁰연세대학교 의과대학 응급의학교실
¹¹서울대학교 의과대학 응급의학교실
¹²인하대학교 의과대학 응급의학교실
¹³한림대학교 의과대학 응급의학교실
¹⁴서울아산병원 디자인콘텐츠팀
¹⁵가톨릭대학교 의과대학 응급의학교실
¹⁶가톨릭대학교 성빈센트병원 응급의학과
¹⁷아주대학교 의과대학 응급의학교실
¹⁸남서울대학교 응급구조학과
¹⁹연세대학교 원주의과대학 응급의학교실
²⁰2025년 한국심폐소생술 가이드라인 총괄위원회

Ju Sun Heo¹

, Young Hwa Jung¹

, Sung Phil Chung¹⁰

, Do Kyun Kim¹¹

, Tae-Youn Kim¹²

, Youdong Sohn¹³

, Yunhee Oh¹⁴

, Chun Song Youn¹⁵

, Mi Jin Lee¹⁶

, Jisook Lee¹⁷

, Chang Hee Lee¹⁸

, Youngbin Jang¹⁰

, Yong Soo Jang¹³

, Gyu Chong Cho¹³

, Kyoung-chul Cha¹⁹

, Sung Oh Hwang¹⁹

Correspondence

Gyuhong Shim ,Tel: 02-950-1632, Fax: 02-950-1246, Email: peddoc@paik.ac.kr,

Received: February 21, 2026; Revised: April 25, 2026 Accepted: June 10, 2026. Published online: June 30, 2026.
*Ju Sun Heo and Young Hwa Jung contributed equally to this work.

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 long-term neurodevelopmental outcomes.

Key words: Heart arrest; Neonates; Resuscitation