Journal Article

ASSESSMENT OF HEART RATE USING AUSCULTATION AND ELECTROCARDIOGRAPHY DURING NEONATAL RESUSCITATION IN A PORCINE MODEL OF ASPHYXIA

Sparsh Patel, Po-Yin Cheung, Tze-Fun Lee, Jannatul Mustofa, Matteo Pasquin, Megan O’Reilly and Georg Schmolzer

in Paediatrics & Child Health

Published on behalf of Canadian Paediatric Society

Volume 23, issue suppl_1 Published in print May 2018 | ISSN: 1205-7088
Published online May 2018 | e-ISSN: 1918-1485 | DOI: https://dx.doi.org/10.1093/pch/pxy054.070
ASSESSMENT OF HEART RATE USING AUSCULTATION AND ELECTROCARDIOGRAPHY DURING NEONATAL RESUSCITATION IN A PORCINE MODEL OF ASPHYXIA

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  • Neonatology
  • Primary Care
  • Child and Adolescent Psychiatry
  • Clinical Child and Adolescent Psychology
  • Developmental Psychology

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Abstract

BACKGROUND

Recent neonatal resuscitation guidelines have suggested the potential benefit of introducing Electrocardiography (ECG) to monitor neonatal heart rate (HR) as standard of care for newborns receiving respiratory support in the delivery room due to advantages over auscultation.

OBJECTIVES

To assess effectiveness of HR detection using either ECG or auscultation.

DESIGN/METHODS

We reviewed recordings from our piglet neonatal resuscitations to compare an ECG with auscultation for assessing the detection of HR at cardiac arrest. Term newborn piglets (n=41) were anesthetized, intubated, instrumented, and exposed to 40-min normocapnic hypoxia followed by asphyxia, which was achieved by clamping the endotracheal tube until asystole. Asystole was confirmed by using Electrocardiography and auscultation.

RESULTS

The median (±IQR) duration of asphyxia was 318 (200–560)sec. In 41 piglets both auscultation and ECG HR were assessed. In 11 (27%) cases both auscultation and ECG correctly identified a bradycardic HR (mean (SD) 32(14)/min) at the beginning of chest compression. In 11 (27%) cases both auscultation and ECG correctly identified absent of any HR. However, in 19 (46%) cases auscultation did not detect a HR while ECG did detect a HR. Overall, the Positive Predictive Value was 37%, Negative Predictive Value was 100%, Sensitivity was 100%, and Specificity was 37% for the ECG to display accurate HR during asphyxia in newborn piglets.

CONCLUSION

Our data illustrates the need for caution in the routine use of ECG monitoring for all neonatal who might need advanced resuscitation in the deliver room.

Journal Article.  0 words. 

Subjects: Neonatology ; Primary Care ; Child and Adolescent Psychiatry ; Clinical Child and Adolescent Psychology ; Developmental Psychology

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