University of South Alabama, Mobile, AL, United States.
University of South Alabama, Mobile, AL, United States.
Resuscitation. 2018 Jul;128:83-87. doi: 10.1016/j.resuscitation.2018.03.038. Epub 2018 Mar 31.
To determine whether heart rate (HR) could be detected earlier than by pulse oximeter (POX), using a novel method of application of electrocardiogram (ECG) electrodes during neonatal resuscitation in the delivery room.
ECG electrodes were set before delivery to be applied to the back of infants' thorax. Time to detect HR was recorded as soon as a numerical HR along with a recognizable and persistent QRS complex was observed on ECG monitor (HRECG) and a plethysmographic waveform was seen on POX monitor (HRPOX).
Out of 334 infants, 49 were <31 weeks of gestational age. Overall, the median (interquartile range, IQR) time to detect HRECG was significantly shorter [29 (5, 60) seconds] than time by POX [60 (45,120) seconds], (p < 0.001). Similarly, in <31-week infants, the median (IQR) time to detect HRECG was 10 (2, 40) seconds compared to 60 (30,120) seconds by POX, (p < 0.001). Failure to have HR detected by 1 minute occurred in 30%, 54% and 20% of infants by ECG, POX and either of the devices, respectively.
In the delivery room, electrodes applied by the study method are more effective than pulse oximetry in providing the neonatal team with timely HR information that is necessary for proper resuscitative actions.
通过一种在产房新生儿复苏中应用心电图（ECG）电极的新方法，确定是否可以比脉搏血氧仪（POX）更早地检测到心率（HR）。
在分娩前设置 ECG 电极，以便应用于婴儿胸部的背部。当在 ECG 监测器（HRECG）上观察到数字 HR 以及可识别和持续的 QRS 复合物，并且在 POX 监测器（HRPOX）上看到体积描记波时，记录检测 HR 的时间。
在 334 名婴儿中，有 49 名胎龄<31 周。总体而言，检测 HRECG 的中位数（四分位距，IQR）时间明显短于 POX [29（5，60）秒] [60（45，120）秒]，（p<0.001）。同样，在<31 周的婴儿中，检测 HRECG 的中位数（IQR）时间为 10（2，40）秒，而 POX 为 60（30，120）秒，（p<0.001）。在 1 分钟内未检测到 HR 的发生率分别为 30%、54%和 20%，通过 ECG、POX 和任一种设备。
在产房，与脉搏血氧仪相比，通过研究方法应用的电极在为新生儿团队提供必要的及时 HR 信息方面更有效，这对于适当的复苏行动是必要的。
