Henry Caroline, Shipley Lara, Ward Carole, Mirahmadi Siavash, Liu Chong, Morgan Steve, Crowe John, Carpenter James, Hayes-Gill Barrie, Sharkey Don
Division of Child Health, Obstetrics & Gynaecology, University of Nottingham, Nottingham, UK.
Faculty of Engineering, University of Nottingham, Nottingham, UK.
Acta Paediatr. 2021 Jan;110(1):72-78. doi: 10.1111/apa.15303. Epub 2020 May 18.
A device for newborn heart rate (HR) monitoring at birth that is compatible with delayed cord clamping and minimises hypothermia risk could have advantages over current approaches. We evaluated a wireless, cap mounted device (fhPPG) for monitoring neonatal HR.
A total of 52 infants on the neonatal intensive care unit (NICU) and immediately following birth by elective caesarean section (ECS) were recruited. HR was monitored by electrocardiogram (ECG), pulse oximetry (PO) and the fhPPG device. Success rate, accuracy and time to output HR were compared with ECG as the gold standard. Standardised simulated data assessed the fhPPG algorithm accuracy.
Compared to ECG HR, the median bias (and 95% limits of agreement) for the NICU was fhPPG -0.6 (-5.6, 4.9) vs PO -0.3 (-6.3, 6.2) bpm, and ECS phase fhPPG -0.5 (-8.7, 7.7) vs PO -0.1 (-7.6, 7.1) bpm. In both settings, fhPPG and PO correlated with paired ECG HRs (both R = 0.89). The fhPPG HR algorithm during simulations demonstrated a near-linear correlation (n = 1266, R = 0.99).
Monitoring infants in the NICU and following ECS using a wireless, cap mounted device provides accurate HR measurements. This alternative approach could confer advantages compared with current methods of HR assessment and warrants further evaluation at birth.
一种用于出生时新生儿心率（HR）监测的设备，若能与延迟脐带结扎兼容并将体温过低风险降至最低，可能比当前方法更具优势。我们评估了一种用于监测新生儿心率的无线头戴式设备（fhPPG）。
共招募了52名新生儿重症监护病房（NICU）的婴儿以及择期剖宫产（ECS）出生后即刻的婴儿。通过心电图（ECG）、脉搏血氧饱和度测定（PO）和fhPPG设备监测心率。将成功率、准确性和心率输出时间与作为金标准的心电图进行比较。标准化模拟数据评估了fhPPG算法的准确性。
与心电图心率相比，NICU中fhPPG的中位数偏差（及95%一致性界限）为-0.6（-5.6，4.9）次/分钟，而PO为-0.3（-6.3，6.2）次/分钟；ECS阶段fhPPG为-0.5（-8.7，7.7）次/分钟，而PO为-0.1（-7.6，7.1）次/分钟。在两种情况下，fhPPG和PO均与配对的心电图心率相关（两者R = 0.89）。模拟过程中fhPPG心率算法显示出近乎线性的相关性（n = 1266，R = 0.99）。
使用无线头戴式设备对NICU中的婴儿和ECS后的婴儿进行监测可提供准确的心率测量值。与当前心率评估方法相比，这种替代方法可能具有优势，值得在出生时进行进一步评估。
