Author Of 1 Presentation
FEASIBILITY OF ELECTROCARDIOGRAM IN HEART RATE ASSESSMENT AND COMPARISON WITH PULSE OXIMETER IN THE DELIVERY ROOM
Abstract
Background
Heart rate (HR) measurement is critical in guiding early interventions in neonatal resuscitation. Conventional methods for HR assessment rely on auscultation and use of pulse oximeter (POX) for pulse rate (PR). Recent guidelines recommend the use of the electrocardiogram (ECG) in HR assessment during resuscitation, however there have been barriers to implementation including clinical feasibility and potential risk to the newborn.
Objectives
The aim of the study was to assess the feasibility of ECG with POX by comparing time to application of ECG electrodes vs POX sensors; time to first reliable HR/PR; and agreement of POX against ECG.
Methods
A cross sectional study. All pre-term and term deliveries from October 2018 to March 2019 were included. At delivery, neonates had both ECG/POX sensors applied from the time the neonate was put under the radiant warmer with continuous monitoring of HR/PR for 10 minutes or until transfer. Reporting of adverse side effects was monitored. Data was compared using a Mann-Whitney U test and agreement analysed using a Bland-Altman plot.
Results
Based on data collected so far (n=28), time to apply ECG [median= 25s(21,34)] vs POX [median = 37s(27.5, 42.25)] was significantly different (p=0.004). Time to display a reliable HR [median= 6.5s(5,15.25)] was also significantly different from POX [median= 65s(32,100.5)] (p=0.000). Bland-Altmann Plot showed reasonable agreement [mean= 7.57bpm(-33.92,49.06)].
Conclusion
ECG provided faster and more accurate display of HR during resuscitation, providing clinicians with a more reliable assessment of HR.