Recent Recommendations and Emerging Science in Neonatal Resuscitation

Escobedo, Marilyn; Shah, Birju A.; Song, Clara; Makkar, Abhishek; Szyld, Edgardo

doi:10.1016/j.pcl.2018.12.002

Cited by 23 publications

(23 citation statements)

References 52 publications

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“…Video recording has also shown its potential in the field of medical training through simulation [5] and e-learning [6] and has started to emerge in healthcare services. While the use of video is currently not common practice in neonatology, it has increased to meet new needs such as photoplethysmography, video laryngoscopy or webcams to enable virtual visit [7][8][9]. Webcams have been used [10][11][12][13][14] for several years either to limit the impact of parent-child separation or when parental presence is limited to promote early emotional bonding and reduce separation anxiety.…”

Section: Introductionmentioning

confidence: 99%

Parents’ and healthcare professionals’ perceptions of the use of live video recording in neonatal units: a focus group study

BRIS¹,

Mazille-Orfanos²,

Simonot

et al. 2020

BMC Pediatr

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Background: The emerging use of video in neonatology units raises ethical and practical questions. This study aims to gain a better understanding of the suitability, limitations and constraints concerning the use of live video as a tool in neonatal clinical practice. The perceptions of parents and healthcare professionals in regard to live video were examined. Methods: Nine focus groups were conducted in four neonatal units involving 20 healthcare professionals and 19 parents. Data were triangulated using transcripts and field notes and analyzed using inductive and semantic thematic analysis. Results: The seven major themes that emerged from the healthcare professionals focus groups were (i) the impact of video recording on healthcare professionals' behavior; (ii) the impact on parents; (iii) forensic issues;(iv) guarantee of use; (v) benefits for the newborn; (vi) methodology of use; and (vii) technical considerations & feasibility. The five major themes that emerged from parents focus groups were (i) benefits for the newborn and care enhancement; (ii) impact on parents and potential benefits in case of newborn child/parent separation; (iii) informed consent and guarantee of use;(iv) concern about a possible disruptive impact on healthcare professionals; and (v) data protection. Conclusion: Both parents and healthcare professionals found video recording useful and acceptable if measures were taken to protect the data and mitigate any negative impacts on healthcare professionals.

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Section: Introductionmentioning

confidence: 99%

Parents’ and healthcare professionals’ perceptions of the use of live video recording in neonatal units: a focus group study

BRIS¹,

Mazille-Orfanos²,

Simonot

et al. 2020

BMC Pediatr

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“…3 Heart rate is the critical indicator for signaling the need for intervention in neonatal resuscitation and evaluating the patient's response to these interventions. 4 A rising heart rate remains the cardinal indicator of a successful intervention response. It is, therefore, critically important to utilize a rapid, reliable, and accurate method for measuring the newborn's heart rate.…”

Section: Introductionmentioning

confidence: 99%

Impact of electronic cardiac (ECG) monitoring on delivery room resuscitation and neonatal outcomes

et al. 2019

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Aim: In 2016, the neonatal resuscitation guidelines suggested electronic cardiac (ECG) monitoring to assess heart rate for an infant receiving positive pressure ventilation immediately after birth. Our aim was to study the impact of ECG monitoring on delivery room resuscitation interventions and neonatal outcomes.Methods: Observational cohort study compared maternal, perinatal and infant characteristics, before (retrospective cohort, calendar year 2015) and after (prospective cohort, calendar year 2017) implementation of ECG monitoring in the delivery room. Association of ECG monitoring with delivery room resuscitation practice interventions and neonatal outcomes was assessed using unadjusted and adjusted multivariable regression analyses.Results: Of 632 newly born infants who received positive pressure ventilation in the delivery room, ECG monitoring was performed in 369 (the prospective cohort) compared with no ECG monitoring in 263 (the retrospective cohort). Compared to neonates in the retrospective cohort, neonates with ECG monitoring had a significantly lower endotracheal intubation rate (36% vs 48%, P < .005) in the delivery room and higher 5-min Apgar scores (7 [5-8] vs 6 [5-8], P < .05). There was no difference in mortality (31 [8%] vs 23 [9%]), but infants who received ECG monitoring had increased odds of receiving chest compressions with an adjusted odds ratio of 3.6 (95% confidence interval: 1.4-9.5).Conclusion: Introduction of ECG monitoring in the delivery room was associated with fewer endotracheal intubations, and an increase use of chest compressions with no difference in mortality.

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“…These ongoing synchronous audio-video interactions build upon existing telehealth-based simulation education and NRTP to improve clinical outcomes (11,(23)(24)(25). We were encouraged that our VAR rate was 46.2 percent, higher than the expected 34.5 percent rate reported by Fang et al (26), reporting that 65.5 percent of users "did not use service because they did not have a clinical need."…”

Section: Linear Regression Was Used To Assess the Effect Of The Var Intervention On These Outcomes Unless Noted Otherwisementioning

confidence: 99%

Implementation and Outcomes of a Telehealth Neonatology Program in a Single Healthcare System

et al. 2021

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Background: Intermountain Healthcare, an early adopter and champion for newborn video-assisted resuscitation (VAR), identified a reduction in facility-level transfers and an estimated savings of $1. 2 million in potentially avoided transfers in a 2018 study. This study was conducted to increase understanding of VAR at the individual, newborn level.Study Aim: To compare transfers to a newborn intensive care unit (NICU), length of stay (LOS), and days of life on oxygen between newborns managed by neonatal VAR and those receiving standard care (SC).Methods: This retrospective, nonequivalent group study includes infants born in an Intermountain hospital between 2013 and 2017, 34 weeks gestation or greater, and requiring oxygen support in the first 15 minutes of life. Data came from billing and clinical records from Intermountain's enterprise data warehouse and chart reviews. We used logistic regression to estimate neonatal VAR's impact on transfers. Negative binomial regression estimated the impact on LOS and days of life on supplemental oxygen.Results: The VAR intervention was used in 46.2 percent of post-implementation cases and is associated with (1) a 12 percentage points reduction in the transfer rate, p = 0.02, (2) a reduction in spoke hospital (SH) LOS of 8.33 h (p < 0.01) for all transfers; (3) a reduction in SH LOS of 2.21 h (p < 0.01) for newborns transferred within 24 h; (4) a reduction in SH LOS of 17.85 h (p = 0.06) among non-transferred newborns; (5) a reduction in days of life on supplemental oxygen of 1.4 days (p = 0.08) among all transferred newborns, and (6) a reduction in days of life on supplemental oxygen of 0.41 days (p = 0.04) among non-transferred newborns.Conclusion: This study provides evidence that neonatal VAR improves care quality and increases local hospitals' capabilities to keep patients close to home. There is an ongoing demand for support to rural and community hospitals for urgent newborn resuscitations, and complex, mandatory NICU transfers. Efforts may be necessary to encourage neonatal VAR since the intervention was only used in 46.2 percent of this study's potential cases. Additional work is needed to understand the short- and long-term impacts of Neonatal VAR on health outcomes.

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Recent Recommendations and Emerging Science in Neonatal Resuscitation

Cited by 23 publications

References 52 publications

Parents’ and healthcare professionals’ perceptions of the use of live video recording in neonatal units: a focus group study

Parents’ and healthcare professionals’ perceptions of the use of live video recording in neonatal units: a focus group study

Impact of electronic cardiac (ECG) monitoring on delivery room resuscitation and neonatal outcomes

Implementation and Outcomes of a Telehealth Neonatology Program in a Single Healthcare System

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