Infants randomized into the "CC+SI group" will receive a SI with a PIP of 25-30 cmH2O while receiving chest compression. The SI will be delivered over a period of 45 seconds. This will be followed by PEEP of 5-8 cm water to perform an assessment of the newborn's heart rate. If heart rate is >60/min continue with standard care as per local hospital policy (standard hospital practice guideline). If heart rate remains <60/min continue with CC+SI for another 45sec at which time a further assessment should be performed. If heart rate remains <60/min continue with CC+SI.

Infants randomized into the "3:1 C:V group" will receive CC at a rate of 90/min and 30 ventilations/min in a 3:1 C:V ratio as recommended by the current resuscitation guidelines.

Heart Arrest

Birth Asphyxia

Bradycardia

chest compression will be delivered during sustained inflation (CC+SI). The duration of each sustain inflation is 20sec. After 20sec a pause of 1sec id done before the next sustained inflation is delivered for another 20sec. Chest compressions are given continuously. This approach is continued until return of spontaneous circulation.

CC+SI

During 3:1 C:V. 3 chest compressions are given, then stopped and then 1 inflation is given. This approach is continued until return of spontaneous circulation.

3:1 C:V

Provides public information about the study and has a secure area for investigators

Royal Womens Hospital

King Edward Memorial Hospital for Women

Medical University Graz

Medical University Vienna

Royal Alexandra Hospital

IWK Health Centre

McMaster Children's Hospital

CHU Sainte-Justine

Hong Kong University

University College Cork

Ospedale dei Bambini Vittore Buzzi

Akershus University Hospital

Poznan University of Medical Sciences

Division of Neonatology Department of Pediatrics, Sidra Medicine

SI + CC Versus 3:1 C:V Ratio During Neonatal CPR

SURV1VE-Trial - Sustained Inflation and Chest Compression Versus 3:1 Chest Compression to Ventilation Ratio During Cardiopulmonary Resuscitation of Asphyxiated Newborns: A Randomized Controlled Trial

Duration of chest compression heart rate is >60/min for 60sec.

Number of infants who die until discharge - comparison between group

How many doses of epinephrine are given - comparison between group

Brain injury either by ultrasound or magnet resonance imaging - comparison between group

Number of infants who develop Necrotizing enterocolitis - comparison between group

University of Alberta

Epo is administered 1000 U/kg, iv in 48 hours after premature birth, and at 48 hours interval for 3 doses per week. After 6 doses, Subcutaneously 3 doses per week until at corrected age of 34 weeks.

Normal saline is administered 5ml, iv at 3 to 6 hours after premature birth, and at 48 hours interval for 3 doses per week. After 6 doses, Subcutaneously 3 doses per week until at corrected age of 34 weeks.

Premature Infant

Epo is administered 1000 U/kg, iv in 48 hours after premature birth, and at 48 hours interval for 3 doses per week. After 6 doses, subcutaneously 400 U/Kg per injection and 3 doses per week until at corrected age of 34 weeks.

Normal saline

Children Hospital of Fudan University

Erythropoietin in Premature Infants to Prevent Encephalopathy

Erythropoietin in Premature Infants to Prevent Encephalopathy: A Multi-Centre Randomized Blinded Controlled Study of the Efficacy of Erythropoietin in China

To evaluate neurodevelopmental function via Bayley Scores of Infant Development Mental Development Index (BSID) and gain incidence of MDI<70(Severe) or MDI<85(Moderate).

To gain changes in standardized gross motor function using GMFM (Gross Motor Function Measure) as a standardized measurement tool for assessing Gross Motor Function consisting of sub-scales, lying & rolling, sitting, crawling & kneeling, standing, walking, running & jumping (range: 0~100 , Higher value means better gross motor function).

To compare changes in brain as measured by MRI in Epo treatment and control groups at 9 months.

To compare changes in brain as measured by MRI in Epo treatment and control groups at 18 months.

To compare changes in brain electrophysiology by SSEP at 36 weeks.

To compare changes in brain electrophysiology by SSEP at 18 months.

To compare changes in brain electrophysiology by VEP at 36 weeks.

To compare changes in brain electrophysiology by VEP at 18 months.

To compare changes in brain electrophysiology by BAER at 36 weeks.

To compare changes in brain electrophysiology by BAER at 18 months.

To gain the incidence of Polycythemia, neutropenia, thrombocytopenia, hypertension, sepsis, intraventricular hemorrhage(IVH), periventricular leukomalacia(PVL), seizure, necrotizing enterocolitis (NEC), persistent ductus arterious (PDA), apnea of prematurity, pulmonary haemorrhage, pulmonary hypertension, Prolonged blood coagulation time, retinopathy of prematurity(ROP), cardiac arrhythmia, major venous thrombosis, Renal failure treated with dialysis, pneumonia, pulmonary airleak and chronic lung disease.

Biomarkers for Oxidative Stress, Inflammation and immune response as a measure of efficacy of erythropoietin for hypoxic ischemic encephalopathy.

Children's Hospital of Fudan University

Xiamen Children's Hospital, Fujian of China

Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region

Guangzhou Women and Children's Medical Center

Second Affiliated Hospital of Wenzhou Medical University

Maternal and Child Health Hospital of Hubei Province

The Maternal & Children Health Hospital of Dehong, Yunnan of China

Indocid P.D.A., Merck Frosst, Kirkland, Que., Canada, and Merck, West Point, Pa.

retinopathy of prematurity/seizures

SI + CC Versus 3:1 C:V Ratio During Neonatal CPR

Erythropoietin in Premature Infants to Prevent Encephalopathy

Trial of Indomethacin Prophylaxis in Preterm Infants (TIPP)

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