Evidence map›Paper›PMID 40914342›Full record

Observational studyResuscitation2025

Flow disruptions during delivery room intubation of neonates with congenital diaphragmatic hernia.

Heidi M Herrick, Charis Lim, K Taylor Wild, Jesse Y Hsu, Ken Catchpole, Holly L Hedrick, Natalie E Rintoul, Anne M Ades, Scott Lorch, Elizabeth E Foglia

Abstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Resuscitation, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing 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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

10 authors.

Heidi M HerrickDepartment of Pediatrics, Division of Neonatology, The Children's Hospital of Philadelphia and The University of Pennsylvania Perelman School of Medicine, 2nd Floor, Main Building, 3401 Civic Center Boulevard, Philadelphia, PA 19104, USA. Electronic address: herrickh@chop.edu.
Charis LimDepartment of Pediatrics, Division of Neonatology, The Children's Hospital of Philadelphia and The University of Pennsylvania Perelman School of Medicine, 2nd Floor, Main Building, 3401 Civic Center Boulevard, Philadelphia, PA 19104, USA.
K Taylor WildDepartment of Pediatrics, Division of Neonatology, The Children's Hospital of Philadelphia and The University of Pennsylvania Perelman School of Medicine, 2nd Floor, Main Building, 3401 Civic Center Boulevard, Philadelphia, PA 19104, USA.
Jesse Y HsuDepartment of Biostatistics, Epidemiology, and Informatics at The University of Pennsylvania Perelman School of Medicine, 629 Blockley Hall, 423 Guardian Drive, Philadelphia, PA 19104, USA.
Ken CatchpoleDepartment of Anesthesia and Perioperative Medicine & College of Nursing at The Medical University of South Carolina, Storm Eye Building, 167 Ashley Avenue, Suite 301, MSC 912, Charleston, SC 29425-9120, USA.
Holly L HedrickRichard D. Wood Jr. Center for Fetal Diagnosis and Treatment, Children's Hospital of Philadelphia, 2nd Floor, CHOP Hub for Clinical Collaboration, 3500 Civic Center Boulevard, Philadelphia, PA 19104, USA; Division of Pediatric General, Thoracic, and Fetal Surgery, Children's Hospital of Philadelphia and The University of Pennsylvania Perelman School of Medicine, 2nd Floor, CHOP Hub for Clinical Collaboration, 3500 Civic Center Boulevard, Philadelphia, PA 19104, USA.
Natalie E RintoulDepartment of Pediatrics, Division of Neonatology, The Children's Hospital of Philadelphia and The University of Pennsylvania Perelman School of Medicine, 2nd Floor, Main Building, 3401 Civic Center Boulevard, Philadelphia, PA 19104, USA.
Anne M AdesDepartment of Pediatrics, Division of Neonatology, The Children's Hospital of Philadelphia and The University of Pennsylvania Perelman School of Medicine, 2nd Floor, Main Building, 3401 Civic Center Boulevard, Philadelphia, PA 19104, USA.
Scott LorchDepartment of Pediatrics, Division of Neonatology, The Children's Hospital of Philadelphia and The University of Pennsylvania Perelman School of Medicine, 2nd Floor, Main Building, 3401 Civic Center Boulevard, Philadelphia, PA 19104, USA.
Elizabeth E FogliaDepartment of Pediatrics, Division of Neonatology, The Children's Hospital of Philadelphia and The University of Pennsylvania Perelman School of Medicine, 2nd Floor, Main Building, 3401 Civic Center Boulevard, Philadelphia, PA 19104, USA.

Funding

AHRQ HHS K08 HS029029
6 · The paper itself

Abstract

aimFlow disruptions (FDs) are deviations in the progression of care that compromise safety and efficiency of a specific process. Neonatal intubation is a life-saving high-risk procedure required for delivery room (DR) management of neonates with moderate to severe congenital diaphragmatic hernia (CDH). This study evaluated FDs during DR intubation of neonates with CDH and their association with process and outcome measures.

methodsSingle-center observational study of video-recorded DR intubations of neonates with CDH. FDs were measured from birth through commencement of invasive endotracheal tube ventilation and classified using a neonatal FD tool and impact score. The primary outcome was time to invasive ventilation. Secondary outcomes were time to oxygen saturation (SpO

resultsBetween 11/2021 and 4/2023, 29 video-recorded resuscitations were included. A mean of 7.1 FDs/minute (±3.2) occurred before ventilation. Rate of high impact FDs was associated with a ventilation delay; a one FD/minute increase in rate of high impact FDs was associated with a 19.0 s (95 % confidence interval 4.6-33.4) ventilation delay and delay in pulse oximetry acquisition. Rate of medium impact FDs was associated with a delay in SpO

conclusionFDs occur frequently during DR intubation of neonates with CDH, and high impact FDs are associated with longer time to initiate invasive ventilation. FDs represent modifiable targets to improve CDH intubation and may generalize to other neonatal intubations.

Indexed as

Delivery RoomsHernias, Diaphragmatic, CongenitalIntubation, IntratrachealFemaleHumansInfant, NewbornMaleOximetryOxygen SaturationRespiration, ArtificialVideo RecordingCongenital diaphragmatic herniaDelivery roomFlow disruptionsHuman factorsIntubationResuscitation

Identifiers

PMID40914342
PMCPMC12642386

What OpenQuestion holds

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Registered trials

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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.