What is the most important indicator of successful positive pressure ventilation (PPV)?

The most important indicator of successful positive pressure ventilation (PPV) is the rising heart rate. In the context of neonatal resuscitation, the heart rate is a critical physiological parameter that indicates the effectiveness of ventilation. When a newborn is receiving adequate ventilation and oxygenation, the heart rate typically increases due to improved oxygen delivery to the tissues, which helps in restoring circulatory function.

During resuscitation efforts, a low heart rate can signify inadequate ventilation or oxygenation, necessitating immediate intervention. Conversely, a rising heart rate following PPV indicates that the newborn's body is responding positively to the resuscitative measures, suggesting that oxygenation is improving and that the baby is becoming more stable. This makes it a vital measure to monitor throughout the resuscitation process.

Other indicators, such as improvement in skin color, can also suggest that the infant is responding to resuscitation; however, these signs may not be as directly tied to successful ventilation as the heart rate. Skin color changes can be influenced by other factors, such as ambient temperature or peripheral circulation. Therefore, while they are helpful observations, the rising heart rate serves as a more definitive and immediate measure of the effectiveness of PPV.