Cardiorespiratory Monitoring during Neonatal Resuscitation for Direct Feedback and Audit

Vonderen, Jeroen J van; Zanten, Henriëtte A. van; Schilleman, Kim; Hooper, Stuart B.; Kitchen, Marcus John; Witlox, Ruben S G M; Pas, Arjan B. te

doi:10.3389/fped.2016.00038

Cited by 45 publications

(43 citation statements)

References 85 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The most recent findings of studies using these models have emphasized how important it is that interventions performed during stabilization or resuscitation are based on scientific data gathered from appropriate animal models [6]. Following from this, noncumbersome and noninvasive physiological measurements in human infants during transition have provided more information and permitted testing of whether observations in animals are similar to those in humans [7]. …”

Section: Introductionmentioning

confidence: 99%

The Changing Landscape in Supporting Preterm Infants at Birth

2019

View full text Add to dashboard Cite

Noninvasive ventilation for preterm infants at birth has been recommended and universally adopted. The umbilical cord is often clamped immediately in order to provide the support the infant needs for stabilization. However, recent scientific data from experimental studies that involve animals in transition and human studies using physiological measurements at birth have increased awareness as to how little we know about how these interventions interact and integrate with the infant’s changing physiology. It has become clear that in apneic infants the larynx is closed immediately after birth, which can completely negate the effect of noninvasive ventilation of the lung. For this reason, stimulating and supporting spontaneous breathing could enhance the success of noninvasive ventilation. Animal data also demonstrated that the large swings in blood pressure, blood flow, and oxygenation caused by immediate cord clamping can be avoided by postponing cord clamping until lung aeration has been established. In this review we will focus on these “game changers” that have the potential to completely change the approach used in stabilizing preterm infants at birth.

show abstract

Section: Introductionmentioning

confidence: 99%

The Changing Landscape in Supporting Preterm Infants at Birth

2019

View full text Add to dashboard Cite

show abstract

“…Research, using physiological monitoring and video recording, has shown that it is often too subjective and suboptimal. In this digital age it is now possible to provide the resuscitation team with a detailed objective display of what is happening to the baby and enable them to optimise their techniques and be confident their treatment is appropriate [42].…”

Section: Discussionmentioning

confidence: 99%

Monitoring Neonatal Resuscitation: Why Is It Needed?

Morley¹

2018

Neonatology

View full text Add to dashboard Cite

Stabilisation and resuscitation of babies at birth is one of the most frequently performed procedures and requires considerable skill. If it is not done well, the baby may suffer prolonged hypoxia and bradycardia. Over the last few years there has been a growing interest in carefully evaluating an infant’s condition at birth and the details of what is happening during resuscitation. Clinical assessment of an infant at this time is difficult and often inaccurate. Assessments of heart rate, colour, chest excursions, mask leak, tidal volume, inflation and expiration times, endotracheal intubation, and spontaneous breathing are imprecise. Detailed monitoring of gas flow in and out of the baby, integrated to tidal volume and used to calculate the leak around the face mask or endotracheal tube, together with ventilation pressures, pulse oximetry, ECG, and capnography add objectivity to the clinical assessments. These physiological parameters can be used directly to guide care but are also very useful for debriefing, feedback, audit, teaching, and research. With simultaneous video recording of the resuscitation it is possible to see exactly what is happening during the procedure. Endotracheal intubation is a difficult skill to learn and teach. However, this is now much easier with video laryngoscopy showing the intubator and supervisors exactly what is happening at the larynx.

show abstract

“…Real-time information on vital physiological parameters could improve neonatal resuscitation; with monitoring, these parameters can be kept within the safe range and severe injuries can be prevented 3. Measuring oxygen saturation and heart rate using pulse oximetry is now recommended in the international guidelines.…”

Section: Development Of the Technique Of Recording And Reviewing Neonmentioning

confidence: 99%

“…Although the RFM could remove subjectivity in evaluating neonatal resuscitation,3 it does not provide any interpretation of the signals or a diagnosis. Due to caregivers’ possible inexperience and lack of knowledge, misinterpretation of vital physiological parameters may sometimes occur 24.…”

Section: Development Of the Technique Of Recording And Reviewing Neonmentioning

confidence: 99%

“…Applying respiratory support to neonates during transition at birth can be problematic. Establishing effective ventilation is often the key to successful resuscitation, but can be hampered by inadequate resuscitation techniques or subjectivity in monitoring 3. There is increasing evidence that inappropriate respiratory support can have severe consequences 4–6.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Ethical dilemmas of recording and reviewing neonatal resuscitation

Boer

Houtlosser

Zanten

et al. 2018

Arch Dis Child Fetal Neonatal Ed

View full text Add to dashboard Cite

Neonatal resuscitation is provided to approximately 3% of neonates. Adequate ventilation is often the key to successful resuscitation, but this can be difficult to provide. There is increasing evidence that inappropriate respiratory support can have severe consequences. Several neonatal intensive care units have recorded and reviewed neonatal resuscitation procedures for quality assessment, education and research; however, ethical dilemmas sometimes make it difficult to implement this review process. We reviewed the literature on the development of recording and reviewing neonatal resuscitation and have summarised the ethical concerns involved. Recording and reviewing vital physiological parameters and video imaging of neonatal resuscitation in the delivery room is a valuable tool for quality assurance, education and research. Furthermore, it can improve the quality of neonatal resuscitation provided. We observed that ethical dilemmas arise as the review process is operating in several domains of healthcare that all have their specific moral framework with requirements and conditions on issues such as consent, privacy and data storage. These moral requirements and conditions vary due to local circumstances. Further research on the ethical aspects of recording and reviewing is desirable before wider implementation of this technique can be recommended.

show abstract

Cardiorespiratory Monitoring during Neonatal Resuscitation for Direct Feedback and Audit

Cited by 45 publications

References 85 publications

The Changing Landscape in Supporting Preterm Infants at Birth

The Changing Landscape in Supporting Preterm Infants at Birth

Monitoring Neonatal Resuscitation: Why Is It Needed?

Ethical dilemmas of recording and reviewing neonatal resuscitation

Contact Info

Product

Resources

About