Comparison of infant heart rate assessment by auscultation, ECG and oximetry in the delivery room

Murphy, Madeleine; Angelis, Laura De; McCarthy, Laura; O’Donnell, Colm P.

doi:10.1136/archdischild-2017-314367

Cited by 26 publications

(20 citation statements)

References 8 publications

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“…Additionally, Murphy et al determined auscultation and PO underestimated ECG HR by a mean difference (95% confidence interval) of −9 (−15 to −2) and −5 (−12 to 2) bpm, respectively [23]. This supports previous studies, which identified the other techniques underestimate ECG HR for infants with HR >100 bpm.…”

Section: Electrocardiographysupporting

confidence: 61%

“…Accounting for placement, pulse detection, listening window of 6 s, and time required for mental computation, this technique allows for quick approximation of HR. A total HR assessment time ranging from 7-19 s on average have been previously reported for both palpation and auscultation [16,23,24].…”

Section: Auscultation/palpationmentioning

confidence: 99%

“…The vast majority of studies examining the accuracy and reliability of PO for HR assessment utilize ECG for comparison [15]. We have identified six studies comparing PO to ECG for HR assessment in the delivery room [19,23,31,32,38,39] and one in the neonatal intensive care unit (NICU) [40]. While accuracy is most commonly described as the level of association with the gold standard (ECG for most cases), reliability is defined by detection and signal quality of a waveform (PO or ECG).…”

Section: Pulse Oximetrymentioning

confidence: 99%

“…We have identified three randomized clinical trials assessing latency, reliability or neonatal resuscitation outcomes when using ECG for HR assessment through a systematic review [13,20,36,37]. While Murphy et al performed two trials in low-risk infants [23,39], Katheria et al conducted a trial in preterm infants during stabilization at birth [40]. All studies involved blinding and randomized allocation of the infants into a PO or ECG group.…”

Section: Electrocardiographymentioning

confidence: 99%

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Heart Rate Assessment during Neonatal Resuscitation

Johnson

Schmölzer

2020

Healthcare

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Approximately 10% of newborn infants require some form of respiratory support to successfully complete the fetal-to-neonatal transition. Heart rate (HR) determination is essential at birth to assess a newborn’s wellbeing. Not only is it the most sensitive indicator to guide interventions during neonatal resuscitation, it is also valuable for assessing the infant’s clinical status. As such, HR assessment is a key step at birth and throughout resuscitation, according to recommendations by the Neonatal Resuscitation Program algorithm. It is essential that HR is accurate, reliable, and fast to ensure interventions are delivered without delay and not prolonged. Ineffective HR assessment significantly increases the risk of hypoxic injury and infant mortality. The aims of this review are to summarize current practice, recommended techniques, novel technologies, and considerations for HR assessment during neonatal resuscitation at birth.

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Section: Electrocardiographysupporting

confidence: 61%

Section: Auscultation/palpationmentioning

confidence: 99%

Section: Pulse Oximetrymentioning

confidence: 99%

Section: Electrocardiographymentioning

confidence: 99%

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Heart Rate Assessment during Neonatal Resuscitation

Johnson

Schmölzer

2020

Healthcare

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“…All tests were two sided and a p value <0.05 was considered statistically significant. Statistical analysis was performed using R V.3.3.0 (R Foundation for Statistical Computing, Vienna, Austria) 14…”

Section: Methodsmentioning

confidence: 99%

Impact of a mobile application for heart rate assessment in simulated neonatal resuscitation: a randomised controlled cross-over study

Cavallin

Binotti

Ingrassia

et al. 2019

Arch Dis Child Fetal Neonatal Ed

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BackgroundClinical assessment of newborn heart rate (HR) at birth has been reported to be inaccurate. NeoTapAdvancedSupport (NeoTapAS) is a free-of-charge mobile application that showed good accuracy in HR estimation. This study aimed to evaluate the impact of NeoTapAS on timing of HR communication and resuscitation interventions.MethodsThis was a randomised controlled cross-over (AB/BA) study evaluating HR assessment using auscultation plus NeoTapAS compared with auscultation plus mental computation in a high-fidelity simulated newborn resuscitation scenario. Twenty teams each including three paediatric residents were randomly assigned to AB or BA arms. The primary outcome was the timing of the first HR communication. Secondary outcomes included the timing of the following four HR communications and the timing of resuscitation interventions (positive pressure ventilation, chest compressions, intubation and administration of first dose of epinephrine).ResultsNeoTapAS reduced the time to the first HR communication (mean difference −13 s, 95% CI −23 to −4; p=0.009), and the time of initiation of chest compressions (mean difference −68 s, 95% CI −116 to −18; p=0.01) and administration of epinephrine (mean difference −76 s, 95% CI −115 to −37; p=0.0004) compared with mental computation.ConclusionsIn a neonatal resuscitation simulated scenario, NeoTapAS reduced the time to the first HR communication and the time of initiation of chest compressions and administration of epinephrine compared with mental computation. This app can be especially useful in settings with limited availability of monitoring equipment, but further studies in clinical scenarios are warranted.Trial registration numberNCT03730025.

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