What is the recommended chest compression to ventilation ratio during neonatal resuscitation?

• A. 2:1
• B. 3:1
• C. 4:1
• D. 5:1

Answer: (B)

In newborn resuscitation, when the heart rate stays below 60 bpm after effective initial ventilation, the goal is to restore circulation while continuing to oxygenate. The recommended balance is three chest compressions for every one ventilation. This 3:1 ratio provides frequent compressions to support perfusion while still delivering breaths often enough to oxygenate the blood, a crucial point since neonatal arrests are often driven by hypoxia. In practice, this equates to about 90 compressions and 30 ventilations per minute, for roughly 120 total actions per minute. Ratios with more ventilations (like 2:1) would reduce compressions and risk poor perfusion, while ratios with fewer ventilations (4:1 or 5:1) would under-ventilate and worsen oxygen delivery. Therefore, 3:1 is the best-balanced approach for neonatal resuscitation.