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Kapadia VS, Kawakami MD, Strand ML, Hurst CP, Spencer A, Schmölzer GM, Rabi Y, Wyllie J, Weiner G, Liley HG, Wyckoff MH. Fast and accurate newborn heart rate monitoring at birth: A systematic review. Resusc Plus 2024; 19:100668. [PMID: 38912532 PMCID: PMC11190559 DOI: 10.1016/j.resplu.2024.100668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2024] [Revised: 05/10/2024] [Accepted: 05/13/2024] [Indexed: 06/25/2024] Open
Abstract
Aim To examine speed and accuracy of newborn heart rate measurement by various assessment methods employed at birth. Methods A search of Medline, SCOPUS, CINAHL and Cochrane was conducted between January 1, 1946, to until August 16, 2023. (CRD 42021283364) Study selection was based on predetermined criteria. Reviewers independently extracted data, appraised risk of bias and assessed certainty of evidence. Results Pulse oximetry is slower and less precise than ECG for heart rate assessment. Both auscultation and palpation are imprecise for heart rate assessment. Other devices such as digital stethoscope, Doppler ultrasound, an ECG device using dry electrodes incorporated in a belt, photoplethysmography and electromyography are studied in small numbers of newborns and data are not available for extremely preterm or bradycardic newborns receiving resuscitation. Digital stethoscope is fast and accurate. Doppler ultrasound and dry electrode ECG in a belt are fast, accurate and precise when compared to conventional ECG with gel adhesive electrodes. Limitations Certainty of evidence was low or very low for most comparisons. Conclusion If resources permit, ECG should be used for fast and accurate heart rate assessment at birth. Pulse oximetry and auscultation may be reasonable alternatives but have limitations. Digital stethoscope, doppler ultrasound and dry electrode ECG show promise but need further study.
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Affiliation(s)
- Vishal S. Kapadia
- University of Texas Southwestern Medical Center, Dallas, TX, United States
| | | | | | | | - Angela Spencer
- Saint Louis University School of Medicine, St. Louis, MO, United States
| | | | - Yacov Rabi
- University of Calgary, Calgary, Alberta, Canada
| | - Jonathan Wyllie
- James Cook University Hospital, Middlesbrough, United Kingdom
| | - Gary Weiner
- University of Michigan, Ann Arbor, MI, United States
| | - Helen G. Liley
- University of Queensland, South Brisbane, Queensland, Australia
| | - Myra H. Wyckoff
- University of Texas Southwestern Medical Center, Dallas, TX, United States
| | - International Liaison Committee on Resuscitation Neonatal Life Support Task Force1
- University of Texas Southwestern Medical Center, Dallas, TX, United States
- Federal University of Sao Paulo, Sao Paulo, Brazil
- Akron Children’s Hospital, Akron, OH, United States
- Charles Darwin University, Brisbane, Queensland Australia
- Saint Louis University School of Medicine, St. Louis, MO, United States
- University of Alberta, Edmonton, Alberta, Canada
- University of Calgary, Calgary, Alberta, Canada
- James Cook University Hospital, Middlesbrough, United Kingdom
- University of Michigan, Ann Arbor, MI, United States
- University of Queensland, South Brisbane, Queensland, Australia
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2
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Das A, Adams K, Stoicoiu S, Kunhiabdullah S, Mathew A. Amplification of Heart Sounds Using Digital Stethoscope in Simulation-Based Neonatal Resuscitation. Am J Perinatol 2024; 41:e2485-e2488. [PMID: 37399848 DOI: 10.1055/a-2121-8500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/05/2023]
Abstract
OBJECTIVE The accuracy, timeliness, and reliability of the current methods of heart rate (HR) determination in neonatal resuscitation are debatable, each having its own limitations. We aim to compare three methods of HR assessment: (1) traditional stethoscope, (2) electrocardiogram and traditional stethoscope, and (3) digital stethoscope with loudspeaker amplification of heart sounds. STUDY DESIGN This was a simulated crossover experiment using a high-fidelity manikin. Each team with a physician, a nurse, and a respiratory therapist performed the resuscitations using the three methods (three different scenarios) in different order. The person controlling the HR via manikin controller was blinded, but the single recorder and the providers were not. RESULTS Eighteen resuscitations were completed (six teams of three methods each). The time to first HR recording (p < 0.001), total number of HR recorded (p < 0.001), and time to recognize dips in HR was significantly improved in the digital stethoscope group (p = 0.009). CONCLUSION Use of digital stethoscope with amplification improved documentation of HR and earlier recognition of HR changes. KEY POINTS · Amplified heartbeats during neonatal resuscitation improved documentation.. · Amplified infant heartbeats resulted in earlier recognition of HR changes (increase or decrease).. · Providers using this method had greater satisfaction..
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Affiliation(s)
- Anirudha Das
- Department of Neonatology, Cleveland Clinic Children's Hospital, Cleveland, Ohio
| | - Kim Adams
- Department of Neonatology, Cleveland Clinic Children's Hospital, Cleveland, Ohio
| | - Shelagh Stoicoiu
- Department of Neonatology, Cleveland Clinic Children's Hospital, Cleveland, Ohio
| | | | - Ajith Mathew
- Department of Neonatology, Cleveland Clinic Children's Hospital, Cleveland, Ohio
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3
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Abdou A, Krishnan S, Mistry N. Evaluating a Novel Infant Heart Rate Detector for Neonatal Resuscitation Efforts: Protocol for a Proof-of-Concept Study. JMIR Res Protoc 2023; 12:e45512. [PMID: 37782528 PMCID: PMC10580137 DOI: 10.2196/45512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 09/02/2023] [Accepted: 09/04/2023] [Indexed: 10/03/2023] Open
Abstract
BACKGROUND Over 10 million newborns worldwide undergo resuscitation at birth each year. Pediatricians may use electrocardiogram (ECG), pulse oximetry (PO), and stethoscope in determining heart rate (HR), as HR guides the need for and steps of resuscitation. HR must be obtained quickly and accurately. Unfortunately, the current diagnostic modalities are either too slow, obtaining HR in more than a minute, or inaccurate. With time constraints, a reliable robust heart rate detector (HRD) modality is required. This paper discusses a protocol for conducting a methods-based comparison study to determine the HR accuracy of a novel real-time HRD based on 3D-printed dry-electrode single-lead ECG signals for cost-effective and quick HR determination. The HRD's HR results are compared to either clinical-grade ECG or PO monitors to ensure robustness and accuracy. OBJECTIVE The purpose of this study is to design and examine the feasibility of a proof-of-concept HRD that quickly obtains HR using biocompatible 3D-printed dry electrodes for single-lead neonatal ECG acquisition. This study uses a novel HRD and compares it to the gold-standard 3-lead clinical ECG or PO in a hospital setting. METHODS A cross-sectional study is planned to be conducted in the neonatal intensive care unit or postpartum unit of a large community teaching hospital in Toronto, Canada, from June 2023 to June 2024. In total, 50 newborns will be recruited for this study. The HRD and an ECG or PO monitor will be video recorded using a digital camera concurrently for 3 minutes for each newborn. Hardware-based signal processing and patent-pending embedded algorithm-based HR estimation techniques are applied directly to the raw collected single-lead ECG and displayed on the HRD in real time during video recordings. These data will be annotated and compared to the ECG or PO readings at the same points in time. Accuracy, F1-score, and other statistical metrics will be produced to determine the HRD's feasibility in providing reliable HR. RESULTS The study is ongoing. The projected end date for data collection is around July 2024. CONCLUSIONS The study will compare the novel patent-pending 3D-printed dry electrode-based HRD's real-time HR estimation techniques with the state-of-the-art clinical-grade ECG or PO monitors for HR accuracy and examines how fast the HRD provides reliable HR. The study will further provide recommendations and important improvements that can be made to implement the HRD for clinical applications, especially in neonatal resuscitation efforts. This work can be seen as a stepping stone in the development of robust dry-electrode single-lead ECG devices for HR estimations in the pediatric population. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/45512.
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Affiliation(s)
- Abdelrahman Abdou
- Department of Electrical, Computer and Biomedical Engineering, Toronto Metropolitan University, Toronto, ON, Canada
| | - Sridhar Krishnan
- Department of Electrical, Computer and Biomedical Engineering, Toronto Metropolitan University, Toronto, ON, Canada
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4
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Anton O, Dore H, Rendon-Morales E, Aviles-Espinosa R, Seddon P, Wertheim D, Fernandez R, Rabe H. Non-invasive sensor methods used in monitoring newborn babies after birth, a clinical perspective. Matern Health Neonatol Perinatol 2022; 8:9. [DOI: 10.1186/s40748-022-00144-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 10/25/2022] [Indexed: 11/24/2022] Open
Abstract
Abstract
Background
Reducing the global new-born mortality is a paramount challenge for humanity. There are approximately 786,323 live births in the UK each year according to the office for National Statistics; around 10% of these newborn infants require assistance during this transition after birth. Each year around, globally around 2.5 million newborns die within their first month. The main causes are complications due to prematurity and during delivery. To act in a timely manner and prevent further damage, health professionals should rely on accurate monitoring of the main vital signs heart rate and respiratory rate.
Aims
To present a clinical perspective on innovative, non-invasive methods to monitor heart rate and respiratory rate in babies highlighting their advantages and limitations in comparison with well-established methods.
Methods
Using the data collected in our recently published systematic review we highlight the barriers and facilitators for the novel sensor devices in obtaining reliable heart rate measurements. Details about difficulties related to the application of sensors and interfaces, time to display, and user feedback are explored. We also provide a unique overview of using a non-invasive respiratory rate monitoring method by extracting RR from the pulse oximetry trace of newborn babies.
Results
Novel sensors to monitor heart rate offer the advantages of minimally obtrusive technologies but have limitations due to movement artefact, bad sensor coupling, intermittent measurement, and poor-quality recordings compared to gold standard well established methods. Respiratory rate can be derived accurately from pleth recordings in infants.
Conclusion
Some limitations have been identified in current methods to monitor heart rate and respiratory rate in newborn babies. Novel minimally invasive sensors have advantages that may help clinical practice. Further research studies are needed to assess whether they are sufficiently accurate, practical, and reliable to be suitable for clinical use.
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Abstract
The regionalization of neonatal care was implemented with an overarching goal to improve neonatal outcomes.1 This led to centralized neonatal care in urban settings that jeopardized the sustainability of the community level 2 and level 3 Neonatal Intensive Care Units (NICU) in medically underserved areas.2 Coupled with pediatric subspecialist and allied health professional workforce shortages, regionalization resulted in disparate and limited access to subspecialty care.3-6 Innovative telemedicine technologies may offer an alternative and powerful care model for infants in geographically isolated and underserved areas. This chapter describes how telemedicine offerings of remote pediatric subspecialty and specialized programs may bridge gaps of access to specialized care and maintain the clinical services in community NICUs.
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Affiliation(s)
- Abeer Azzuqa
- Division of Newborn Medicine, Department of Pediatrics, University of Pittsburgh School of Medicine and UPMC Children's Hospital of Pittsburgh, Pittsburgh, PA, USA.
| | - Abhishek Makkar
- Division of Newborn Medicine, Department of Pediatrics, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Kerri Machut
- Division of Neonatology, Department of Pediatrics, Northwestern University Feinberg School of Medicine and Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
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6
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Grooby E, He J, Kiewsky J, Fattahi D, Zhou L, King A, Ramanathan A, Malhotra A, Dumont GA, Marzbanrad F. Neonatal Heart and Lung Sound Quality Assessment for Robust Heart and Breathing Rate Estimation for Telehealth Applications. IEEE J Biomed Health Inform 2020; 25:4255-4266. [PMID: 33370240 DOI: 10.1109/jbhi.2020.3047602] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
With advances in digital stethoscopes, internet of things, signal processing and machine learning, chest sounds can be easily collected and transmitted to the cloud for remote monitoring and diagnosis. However, low quality of recordings complicates remote monitoring and diagnosis, particularly for neonatal care. This paper proposes a new method to objectively and automatically assess the signal quality to improve the accuracy and reliability of heart rate (HR) and breathing rate (BR) estimation from noisy neonatal chest sounds. A total of 88 10-second long chest sounds were taken from 76 preterm and full-term babies. Six annotators independently assessed the signal quality, number of detectable beats, and breathing periods from these recordings. For quality classification, 187 and 182 features were extracted from heart and lung sounds, respectively. After feature selection, class balancing, and hyperparameter optimization, a dynamic binary classification model was trained. Then HR and BR were automatically estimated from the chest sound and several approaches were compared.The results of subject-wise leave-one-out cross-validation, showed that the model distinguished high and low quality recordings in the test set with 96% specificity, 81% sensitivity and 93% accuracy for heart sounds, and 86% specificity, 69% sensitivity and 82% accuracy for lung sounds. The HR and BR estimated from high quality sounds resulted in significantly less median absolute error (4 bpm and 12 bpm difference, respectively) compared to those from low quality sounds. The methods presented in this work, facilitates automated neonatal chest sound auscultation for future telehealth applications.
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Johnson PA, Morina N, O'Reilly M, Lee TF, Cheung PY, Schmölzer GM. Evaluation of a Tap-Based Smartphone App for Heart Rate Assessment During Asphyxia in a Porcine Model of Neonatal Resuscitation. Front Pediatr 2019; 7:453. [PMID: 31750281 PMCID: PMC6848456 DOI: 10.3389/fped.2019.00453] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Accepted: 10/18/2019] [Indexed: 02/01/2023] Open
Abstract
Objectives: Heart rate (HR) is the most significant parameter to assess a newborn's clinical status at birth. Recently, novel technologies including smartphone applications have been suggested for HR assessment during neonatal resuscitation. The aim of this study was to evaluate the accuracy, speed, and precision of the NeoTapLifeSupport (NeoTapLS) smartphone application using a digital stethoscope (DS) for HR assessment during neonatal resuscitation. Design: Newborn piglets (n = 20, 1-3 days, 1.7-2.4 kg) were anesthetized, intubated, mechanically ventilated, and subjected to 30 min of hypoxia, followed by asphyxia. Asphyxia was induced by clamping the endotracheal tube and disconnecting the ventilator, until asystole was confirmed by zero carotid blood flow (CBF). Setting: Experimental setting. Subjects: Asphyxia-induced newborn piglets. Interventions: During asphyxia, HR assessments were performed with a DS using the NeoTapLS smartphone application, and compared to 6-s method (6 s), and 10-s method (10 s). Measurements and Main Results: Accuracy of obtained HRs was compared to CBF and electrocardiogram and assessment time using NeoTapLS, 6 s, and 10 s were also measured. The mean(SD) HR with the NeoTapLS was 68(26), compared to CBF with 68(27) bpm, 6 s with 68(27), and 10 s with 66(26) bpm during asphyxia. Bland-Altman analysis revealed no difference between HR using the NeoTapLS, 6 s, 10 s, compared to CBF HR, with NeoTapLS showing the smallest difference between 95% limits of agreement. The median (IQR) time required to obtain a HR using the NeoTapLS was 3(2-4) s, compared to 6(6-7), and 10(10-11) s for 6 and 10 s, respectively. Conclusions: Our data suggests that the NeoTapLS is accurate, fast, and precise during neonatal asphyxia to assess heart rate.
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Affiliation(s)
- Peter A. Johnson
- Centre for the Studies of Asphyxia and Resuscitation, Neonatal Research Unit, Royal Alexandra Hospital, Edmonton, AB, Canada
- Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Nicolò Morina
- Centre for the Studies of Asphyxia and Resuscitation, Neonatal Research Unit, Royal Alexandra Hospital, Edmonton, AB, Canada
- Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Megan O'Reilly
- Centre for the Studies of Asphyxia and Resuscitation, Neonatal Research Unit, Royal Alexandra Hospital, Edmonton, AB, Canada
- Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Tze-Fun Lee
- Centre for the Studies of Asphyxia and Resuscitation, Neonatal Research Unit, Royal Alexandra Hospital, Edmonton, AB, Canada
- Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Po-Yin Cheung
- Centre for the Studies of Asphyxia and Resuscitation, Neonatal Research Unit, Royal Alexandra Hospital, Edmonton, AB, Canada
- Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Georg M. Schmölzer
- Centre for the Studies of Asphyxia and Resuscitation, Neonatal Research Unit, Royal Alexandra Hospital, Edmonton, AB, Canada
- Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
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8
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Johnson PA, Cheung PY, Lee TF, O’Reilly M, Schmölzer GM. Novel technologies for heart rate assessment during neonatal resuscitation at birth – A systematic review. Resuscitation 2019; 143:196-207. [DOI: 10.1016/j.resuscitation.2019.07.018] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Revised: 06/25/2019] [Accepted: 07/09/2019] [Indexed: 11/30/2022]
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9
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Ramanathan A, Zhou L, Marzbanrad F, Roseby R, Tan K, Kevat A, Malhotra A. Digital stethoscopes in paediatric medicine. Acta Paediatr 2019; 108:814-822. [PMID: 30536440 DOI: 10.1111/apa.14686] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Revised: 11/29/2018] [Accepted: 12/04/2018] [Indexed: 12/30/2022]
Abstract
AIM To explore, synthesise and discuss currently available digital stethoscopes (DS) and the evidence for their use in paediatric medicine. METHODS Systematic review and narrative synthesis of digital stethoscope use in paediatrics following searches of OVID Medline, Embase, Scopus, PubMed and Google Scholar databases. RESULTS Six digital stethoscope makes were identified to have been used in paediatric focused studies so far. A total of 25 studies of DS use in paediatrics were included. We discuss the use of digital stethoscope technology in current paediatric medicine, comment on the technical properties of the available devices, the effectiveness and limitations of this technology, and potential uses in the fields of paediatrics and neonatology, from telemedicine to computer-aided diagnostics. CONCLUSION Further validation and testing of available DS devices is required. Comparison studies between different types of DS would be useful in identifying strengths and flaws of each DS as well as identifying clinical situations for which each may be most appropriately suited.
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Affiliation(s)
| | - Lindsay Zhou
- Monash Newborn Monash Children's Hospital Melbourne VIC Australia
| | - Faezeh Marzbanrad
- Department of Electrical and Computer Systems Engineering Monash University Melbourne VIC Australia
| | - Robert Roseby
- Department of Paediatrics Monash University Melbourne VIC Australia
- Department of Paediatric Respiratory Medicine Monash Children's Hospital Melbourne VIC Australia
| | - Kenneth Tan
- Department of Paediatrics Monash University Melbourne VIC Australia
- Monash Newborn Monash Children's Hospital Melbourne VIC Australia
- The Ritchie Centre Hudson Institute of Medical Research Melbourne VIC Australia
| | - Ajay Kevat
- Department of Paediatrics Monash University Melbourne VIC Australia
| | - Atul Malhotra
- Department of Paediatrics Monash University Melbourne VIC Australia
- Monash Newborn Monash Children's Hospital Melbourne VIC Australia
- The Ritchie Centre Hudson Institute of Medical Research Melbourne VIC Australia
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10
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Solevåg AL, Luong D, Lee TF, O'Reilly M, Cheung PY, Schmölzer GM. Non-perfusing cardiac rhythms in asphyxiated newborn piglets. PLoS One 2019; 14:e0214506. [PMID: 30947278 PMCID: PMC6448889 DOI: 10.1371/journal.pone.0214506] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Accepted: 03/14/2019] [Indexed: 11/18/2022] Open
Abstract
Aim We recently demonstrated that asphyxiated piglets commonly had bradycardia displayed on electrocardiography (ECG) while no carotid blood flow (CBF) or audible heart sounds could be detected. Such pulseless electrical activity (PEA) in newborn infants has not previously been thoroughly described. The aim of this study was to further investigate the occurrence of non-perfusing cardiac rhythms in asphyxiated piglets and the potential implications for the success of cardiopulmonary resuscitation (CPR) and short-term survival. Methods Neonatal piglets (1–4 days, 1.7–2.4kg) had their right common carotid artery exposed and enclosed with a real-time ultrasonic flow probe. Heart rate (HR) was continuously measured and recorded using ECG. This allowed simultaneous monitoring of HR via ECG and CBF. The piglets were asphyxiated until cardiac arrest, defined as no CBF and no audible beat upon precordial auscultation. CPR was performed until return of spontaneous circulation (ROSC, defined as a HR ≥100 bpm). ECG traces were retrospectively assessed. Results Nine out of 21 piglets (43%) had QRS-complexes on their ECG while no CBF and no audible heart sounds could be detected. Five (56%) of the piglets with PEA and 12/12 (100%) piglets with asystole at cardiac arrest obtained ROSC (p = 0.02). Thirty-three per cent of the piglets with PEA versus 58% with asystole survived to 4 hours post-ROSC (p = 0.39). Conclusion Cardiac arrest in the presence of a non-perfusing cardiac rhythm on ECG is common in asphyxiated piglets. Clinical arrest in the presence of a non-perfusing cardiac rhythm on ECG may reduce the success of CPR.
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Affiliation(s)
- Anne Lee Solevåg
- Department of Paediatric and Adolescent Medicine, Akershus University Hospital, Lørenskog, Norway
| | - Deandra Luong
- Centre for the Studies of Asphyxia and Resuscitation, Neonatal Research Unit, Royal Alexandra Hospital, Edmonton, Alberta, Canada
- Faculty of Science, University of Alberta, Edmonton, Alberta, Canada
| | - Tze-Fun Lee
- Centre for the Studies of Asphyxia and Resuscitation, Neonatal Research Unit, Royal Alexandra Hospital, Edmonton, Alberta, Canada
- Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Megan O'Reilly
- Centre for the Studies of Asphyxia and Resuscitation, Neonatal Research Unit, Royal Alexandra Hospital, Edmonton, Alberta, Canada
- Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Po-Yin Cheung
- Centre for the Studies of Asphyxia and Resuscitation, Neonatal Research Unit, Royal Alexandra Hospital, Edmonton, Alberta, Canada
- Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Georg M Schmölzer
- Centre for the Studies of Asphyxia and Resuscitation, Neonatal Research Unit, Royal Alexandra Hospital, Edmonton, Alberta, Canada
- Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
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11
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Treston BP, Semberova J, Kernan R, Crothers E, Branagan A, O'Cathain N, Miletin J. Assessment of neonatal heart rate immediately after birth using digital stethoscope, handheld ultrasound and electrocardiography: an observational cohort study. Arch Dis Child Fetal Neonatal Ed 2019; 104:F227. [PMID: 30355779 DOI: 10.1136/archdischild-2018-315619] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/27/2018] [Indexed: 11/04/2022]
Affiliation(s)
- Bryony P Treston
- Department of Neonatology, Coombe Women and Infants University Hospital, Dublin, Ireland
| | - Jana Semberova
- Department of Neonatology, Coombe Women and Infants University Hospital, Dublin, Ireland.,Department of Neonatology, Institute for the Care of Mother and Child, Prague, Czech Republic
| | - Robert Kernan
- Department of Neonatology, Coombe Women and Infants University Hospital, Dublin, Ireland
| | - Erica Crothers
- Department of Neonatology, Coombe Women and Infants University Hospital, Dublin, Ireland
| | - Aoife Branagan
- Department of Neonatology, Coombe Women and Infants University Hospital, Dublin, Ireland
| | - Niamh O'Cathain
- Department of Neonatology, Coombe Women and Infants University Hospital, Dublin, Ireland
| | - Jan Miletin
- Department of Neonatology, Coombe Women and Infants University Hospital, Dublin, Ireland.,Department of Neonatology, Institute for the Care of Mother and Child, Prague, Czech Republic.,UCD School of Medicine and Medical Science, Dublin, Ireland.,Third School of Medicine, Charles University, Prague, Czech Republic
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12
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Abstract
Resuscitation algorithms and guidelines highlight the importance of heart rate (HR) in determining interventions and assessing their effect. However, the actual HR values used are historical based upon normal physiology, and HR at birth may be affected by mode of delivery and timing of cord clamping as well as respiratory status and condition at delivery. Furthermore, the most accurate and effective ways to assess and monitor HR in the newborn infant are only now becoming established. This article examines the importance of HR values and the most widely used methods of estimation as well as some newer modalities which are being developed.
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13
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Roehr CC, O'Shea JE, Dawson JA, Wyllie JP. Devices used for stabilisation of newborn infants at birth. Arch Dis Child Fetal Neonatal Ed 2018; 103:F66-F71. [PMID: 29079652 DOI: 10.1136/archdischild-2016-310797] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Accepted: 10/03/2017] [Indexed: 01/08/2023]
Abstract
This review examines devices used during newborn stabilisation. Evidence for their use to optimise the thermal, respiratory and cardiovascular management in the delivery room is presented. Mechanisms of action and rationale of use are described, current developments are presented and areas of future research are highlighted.
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Affiliation(s)
- Charles C Roehr
- Department of Paediatrics, Newborn Services, John Radcliffe Hospital, Oxford University Hospitals, NHS Foundation Trust, Oxford, UK
| | - Joyce E O'Shea
- Department of Neonatology, Royal Hospital for Children, Glasgow, UK
| | - Jennifer A Dawson
- Department of Newborn Research, The Royal Women's Hospital, Parkville, Victoria, Australia
| | - Jonathan P Wyllie
- Department of Neonatology, James Cook University Hospital, Middlesbrough, UK.,Resuscitation Council, London, UK.,University of Durham, Durham, UK
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