**1. Introduction**

Most newborn infants successfully transition from fetal to neonatal life without any help [1]. However, approximately 10–20% of newborns (13–26 million worldwide) need some degree of respiratory support at birth [2–4], which remains the most critical step of neonatal resuscitation. Furthermore, an estimated 0.1% of term infants and up to 15% of preterm infants (2–3 million worldwide) requires extensive cardiopulmonary resuscitation (CPR) at birth,

which entails chest compressions (CC) and 100% oxygen with or without administration of epinephrine [5–9]. Despite receiving CPR, approximately 1 million newborns die annually worldwide. Even with successful resuscitation, infants receiving extensive CPR in the delivery room have a high incidence of mortality (40–80%) and neurologic morbidity (e.g. 57% hypoxic–ischemic encephalopathy and seizures) [5, 6, 9]. Therefore, resuscitation techniques require further refinement to provide better outcomes. The guidelines for neonatal resuscitation recommended by the American Academy of Pediatrics/American Heart Association Neonatal Resuscitation Program [2–4] are based, in part, on the recognition that the cause of cardiovascular collapse in most newborns is asphyxia. However, in many cases the guidelines rely on data from studies in the adult population and extrapolate it to the neonatal population. Such data may not be entirely applicable to the neonatal population, because the most common cause of cardiovascular collapse in the adult population is primary cardiac compromise/ventricular fibrillation, not asphyxia. Therefore it is imperative that pre-clinical studies with appropriate animal models are carried out to determine the optimal resuscitation techniques before they are translated into the delivery room for newborn infants.
