Feasibility of a prototype newborn resuscitation monitor to study transition at birth, measuring heart rate and ventilator parameters, an animal experimental study.

BACKGROUND

Every year, an estimated 10 million babies are born, non-breathing and in need of resuscitation. Advances in management have been made over the past decades, however, approximately 700.000 yearly deaths result from this global problem. A prototype newborn resuscitation monitor (NRM) (Laerdal Global Health, Stavanger, Norway) has been developed with the purpose of studying newborn resuscitation. The monitor has the ability to continuously display HR using dry electrode ECG technology, to measure tidal volume, pressure and end tidal CO, and to store the results for later analysis. Such monitor could enhance the care providers performance, and hence survival of neonates, by displaying the quality and response of the given care. The aim of this preclinical study was to describe the abilities of the NRM to measure ventilation and heart rate parameters against pathophysiological responses to different induced conditions in a piglet i.e. increased deadspace, pressure and washout of surfactant.

METHODS

Piglets were chosen for the study, as they have tidal volumes of approximately 6 ml/kg, resembling the human neonate. Five piglets were anesthetized and intubated before starting positive pressure ventilation (PPV). The dry electrode ECG sensor of the NRM was placed over the abdomen, and experiments performed: (1) inducing different ventilation scenarios and (2) lavage of surfactant.

RESULTS

The NRM was capable of continuously displaying HR and detecting inflicted changes in ventilation and compliance of piglets. It could measure inflated and exhaled volume, the pressure of the ventilations and also the end tidal CO.

CONCLUSIONS

The NRM provides objective feedback in anesthetized animals, and may be used in clinical studies and hopefully generate new knowledge on neonatal transition and resuscitation. The monitor may be further developed for use in both low and high-resource settings.