Evidence map›Paper›PMID 39341942›Full record

Trial reportPediatric research2025

Teleneonatal or routine resuscitation in extremely preterm infants: a randomized simulation trial.

Samuel J Gentle, Sarah G Trulove, Nicholas Rockwell, Chrystal Rutledge, Stacy Gaither, Carrie Norwood, Eric Wallace, Waldemar A Carlo, Nancy M Tofil

Registry-linked trialAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Pediatric research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04258722 (Reducing Adverse Delivery Outcomes Through Teleneonatology), which is not on this map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT04258722 nacompletednot on this map

Reducing Adverse Delivery Outcomes Through Teleneonatology: A Feasibility Study

TypeinterventionalSponsorUniversity of Alabama at BirminghamRan2020 to 2023Enrolled51ConditionsNewborn MorbidityArmsResuscitation Personnel
3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Samuel J GentleDepartment of Pediatrics, The University of Alabama at Birmingham, Birmingham, AL, USA. sjgentle@uabmc.edu.
Sarah G TruloveDepartment of Pediatrics, The University of Alabama at Birmingham, Birmingham, AL, USA.
Nicholas RockwellDepartment of Pediatrics, The University of Alabama at Birmingham, Birmingham, AL, USA.
Chrystal RutledgeDepartment of Pediatrics, The University of Alabama at Birmingham, Birmingham, AL, USA.
Stacy GaitherDepartment of Pediatrics, The University of Alabama at Birmingham, Birmingham, AL, USA.
Carrie NorwoodDepartment of Pediatrics, The University of Alabama at Birmingham, Birmingham, AL, USA.
Eric WallaceDepartment of Medicine, The University of Alabama at Birmingham, Birmingham, AL, USA.
Waldemar A CarloDepartment of Pediatrics, The University of Alabama at Birmingham, Birmingham, AL, USA.
Nancy M TofilDepartment of Pediatrics, The University of Alabama at Birmingham, Birmingham, AL, USA.

Funding

Kaul Pediatric Research Institute
6 · The paper itself

Abstract

objectiveTeleneonatology, the use of telemedicine for newborn resuscitation and care, can connect experienced care providers with high-risk deliveries. In a simulated resuscitation, we hypothesized that teleneonatal resuscitation, compared to usual resuscitation, would reduce the no-flow fraction. STUDY

designThis was a single-center, randomized simulation trial in which pediatric residents were randomized to teleneonatal or routine resuscitation. The primary outcome was no-flow fraction defined as time without chest compressions divided by the time during which the heart rate was <60. Secondary outcomes included corrective modifications of bag-mask ventilation and times to intubation and epinephrine administration.

resultsFifty-one residents completed the scenario. The no-flow fraction (median [IQR]) was significantly better in the teleneonatal group (0.06[0.05]) compared to the routine resuscitation group (0.07[0.82]); effect (95% CI): -16 (-43 to 0). Participants in the teleneonatal resuscitation group more frequently performed corrective modifications to bag-mask ventilation (60% vs 15%; p < 0.001). Time to intubation (214 s vs 230 s; p = 0.58) and epinephrine (395 s vs 444 s; p = 0.21) were comparable between groups.

conclusionsIn this randomized simulation trial of neonatal resuscitation, teleneonatal resuscitation reduced adverse delivery outcomes compared to routine care. Further in hospital evaluation of teleneonatology may substantiate this technology's impact on delivery outcomes. CLINICALTRIALS: GOV ID: NCT04258722 IMPACT: Whereas telemedicine-supported neonatal resuscitation may improve the quality of resuscitation within hospital settings, unique challenges include the need for real-time, high-fidelity audio-video communication with a low failure rate. The no-flow fraction, which evaluates the quality of chest compressions when indicated, has been associated with survival in other clinical contexts. We report a reduction in no-flow fraction in neonatal resuscitations supported with telemedicine, in addition to improvements in the quality of neonatal resuscitation. Telemedicine-supported neonatal resuscitation may improve the quality of resuscitation within hospital settings without direct access to neonatologists.

Indexed as

Cardiopulmonary ResuscitationInfant, Extremely PrematureResuscitationTelemedicineEpinephrineFemaleHumansInfant, NewbornInternship and ResidencyMaleEpinephrine

Identifiers

PMID39341942
PMCPMC11798843

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.