ArticleChildren (Basel, Switzerland)2025
Impact of Heart Rate Monitoring Using Dry-Electrode ECG Immediately After Birth on Time to Start Ventilation: A Randomized Trial.
Article in Children (Basel, Switzerland), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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12 authors.
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Abstract
BACKGROUND/
objectivesNewborn heart rate is an integral part of resuscitation algorithms, but the impact of ECG monitoring on resuscitative interventions and clinical outcomes has been identified as a knowledge gap. The objective was to evaluate the impact of routine use of dry-electrode ECG in all newborns immediately after birth on time to start positive pressure ventilation (PPV) when indicated.
methodsWe conducted a randomized clinical trial from June 2019 to November 2021 at Stavanger University Hospital, Norway. Dry-electrode ECG sensors were applied immediately after birth to all newborns ≥ 34 weeks' gestation. Randomization determined whether the heart rate display was visible or masked. Time of birth was registered in an observation app. Time to start ventilation was calculated from video recordings.
resultsIn total, 7343 newborns ≥ 34 weeks' gestation were enrolled, 4284 in the intervention and 3059 in the control group, and 3.7% and 3.8% received ventilation, respectively. In 171/275 (62%) of the newborns the exact time of birth and a video of the resuscitation were available, for 98 in the intervention and 73 in the control group. Ventilation was provided within 60 s to 44/98 (45%) in the intervention and 24/73 (33%) in the control group,
conclusionsThe use of dry-electrode ECG heart rate monitoring did not change the proportion of newborns that received ventilation within 60 s after birth, but early termination due to employee protests to video recordings rendered the trial inadequately powered to detect a difference. Breathing status was likely a more important determinant of starting ventilation than bradycardia.
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