Randomised study comparing heart rate measurement in newly born infants using a monitor incorporating electrocardiogram and pulse oximeter versus pulse oximeter alone

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

doi:10.1136/archdischild-2017-314366

Cited by 25 publications

(19 citation statements)

References 16 publications

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“…1,9,10 The NLS Task Force undertook an EvUp to identify additional evidence published after 2015 that would warrant consideration of a new SysRev. The EvUp (Supplement Appendix C-3) identified 7 additional studies published after the 2015 CoSTR SysRev, 1,9,10 including 2 SysRevs, 44,45 2 RCTs, 46,47 and 3 observational studies. 48À 50 All 7 studies supported the 2015 treatment recommendation.…”

Section: Heart Rate Monitoring During Neonatal Resuscitation (Nls 898: Evup)mentioning

confidence: 99%

Neonatal Life Support 2020 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations

Wyckoff¹,

Wyllie²,

Aziz³

et al. 2020

Resuscitation

102

114

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This 2020 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With TreatmentRecommendations (CoSTR) for neonatal life support includes evidence from 7 systematic reviews, 3 scoping reviews, and 12 evidence updates.The Neonatal Life Support Task Force generally determined by consensus the type of evidence evaluation to perform; the topics for the evidence updates followed consultation with International Liaison Committee on Resuscitation member resuscitation councils. The 2020 CoSTRs for neonatal life support are published either as new statements or, if appropriate, reiterations of existing statements when the task force found they remained valid.Evidence review topics of particular interest include the use of suction in the presence of both clear and meconium-stained amniotic fluid, sustained inflations for initiation of positive-pressure ventilation, initial oxygen concentrations for initiation of resuscitation in both preterm and term infants, use of epinephrine (adrenaline) when ventilation and compressions fail to stabilize the newborn infant, appropriate routes of drug delivery during resuscitation, and consideration of when it is appropriate to redirect resuscitation efforts after significant efforts have failed.All sections of the Neonatal Resuscitation Algorithm are addressed, from preparation through to postresuscitation care. This document now forms the basis for ongoing evidence evaluation and reevaluation, which will be triggered as further evidence is published.Over 140 million babies are born annually worldwide (https://ourworldindata.org/grapher/births-and-deaths-projected-to-2100). If up to 5% receive positive-pressure ventilation, this evidence evaluation is relevant to more than 7 million newborn infants every year. However, in terms of early care of the newborn infant, some of the topics addressed are relevant to every single baby born.

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Section: Heart Rate Monitoring During Neonatal Resuscitation (Nls 898: Evup)mentioning

confidence: 99%

Neonatal Life Support 2020 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations

Wyckoff¹,

Wyllie²,

Aziz³

et al. 2020

Resuscitation

102

114

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“…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%

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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“…To obtain rapid and reliable heart rate monitoring during newborn resuscitation is challenging. Comparative studies show that electrocardiogram (ECG) provide feedback of heart rate earlier than pulse oximetry, and pulse oximetry can underestimate initial heart rate [4][5][6][7][8][9]. The International Liaison Committee on Resuscitation (ILCOR) suggests using ECG for accurate estimation of heart rate during newborn resuscitation, and emphasizes the importance of speed and reliablity [3,10].…”

Section: Introductionmentioning

confidence: 99%

Heart rate detection properties of dry-electrode ECG compared to conventional 3-lead gel-electrode ECG in newborns

et al. 2021

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Objective To compare the accuracy of heart rate detection properties of a novel, wireless, dry-electrode electrocardiogram (ECG) device, NeoBeat®, to that of a conventional 3-lead gel-electrode ECG monitor (PropaqM®) in newborns. Results The study population had a mean gestational age of 39 weeks and 2 days (1.5 weeks) and birth weight 3528 g (668 g). There were 950 heart rate notations from each device, but heart rate was absent from the reference monitor in 14 of these data points, leaving 936 data pairs to compare. The mean (SD) difference when comparing NeoBeat to the reference monitor was -0.25 (9.91) beats per minute (bpm) (p = 0.44). There was a deviation of more than 10 bpm in 7.4% of the data pairs, which primarily (78%) was attributed to ECG signal disturbance, and secondly (22%) due to algorithm differences between the devices. Excluding these outliers, the correlation was equally consistent (r2 = 0.96) in the full range of heart rate captured measurements with a mean difference of − 0.16 (3.09) bpm. The mean difference was less than 1 bpm regardless of whether outliers were included or not.

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Randomised study comparing heart rate measurement in newly born infants using a monitor incorporating electrocardiogram and pulse oximeter versus pulse oximeter alone

Cited by 25 publications

References 16 publications

Neonatal Life Support 2020 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations

Neonatal Life Support 2020 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations

Heart Rate Assessment during Neonatal Resuscitation

Heart rate detection properties of dry-electrode ECG compared to conventional 3-lead gel-electrode ECG in newborns

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