Department of Pediatrics, School of Medicine, University of North Carolina, Chapel Hill, North Carolina.
Laerdal Medical, Stavanger, Norway.
Pediatrics. 2020 Oct;146(Suppl 2):S155-S164. doi: 10.1542/peds.2020-016915H.
Ninety percent of intrapartum-related neonatal deaths are attributable to respiratory depression, with the vast majority of these deaths occurring in low- and lower-middle-income countries. Neonatal resuscitation training with Helping Babies Breathe (HBB) decreases mortality from respiratory depression. Cardiorespiratory monitoring in conjunction with HBB can provide valuable resuscitation feedback for both training and bedside purposes. In this article, we discuss 3 innovations that couple cardiorespiratory monitoring with HBB: NeoNatalie Live, the Augmented Infant Resuscitator, and NeoBeat. NeoNatalie Live is a high-fidelity manikin that facilitates bag mask ventilation training through case scenarios of varying difficulty. The Augmented Infant Resuscitator is added in-line between a face mask and ventilation bag during bag mask ventilation training to provide users with real-time feedback on ventilation quality. NeoBeat is a battery-operated heart rate meter that digitally displays the newborn heart rate during bedside resuscitations. For each innovation, we review details of the device, implementation in the field, and areas for further research. Using early experience implementing these devices, we suggest building blocks for effective translation of training into improved care. We also highlight general challenges in implementation of devices in facilities in low- and lower-middle-income countries including considerations for training, adaptations to existing workflow, and integration into the ecosystem. Although the devices highlighted in this article hold promise, more data are needed to understand their impact on newborn outcomes.
90%的产时相关新生儿死亡可归因于呼吸抑制，其中绝大多数死亡发生在中低收入国家。使用《帮助婴儿呼吸》（Helping Babies Breathe，HBB）进行新生儿复苏培训可降低呼吸抑制导致的死亡率。与 HBB 联合使用心肺监测可为培训和床边复苏提供有价值的反馈。本文讨论了 3 种将心肺监测与 HBB 结合的创新技术：NeoNatalie Live、增强型婴儿复苏器和 NeoBeat。NeoNatalie Live 是一种高保真人体模型，通过不同难度的案例场景促进了气囊面罩通气的培训。增强型婴儿复苏器在气囊面罩通气培训期间在线添加在面罩和通气袋之间，为用户提供通气质量的实时反馈。NeoBeat 是一种电池供电的心率计，可在床边复苏期间数字显示新生儿心率。对于每项创新，我们都回顾了设备的详细信息、在现场的实施情况以及进一步研究的领域。根据我们在早期实施这些设备的经验，我们提出了将培训转化为改善护理的有效方法。我们还强调了在中低收入国家的设施中实施设备所面临的一般挑战，包括培训考虑、对现有工作流程的调整以及与生态系统的整合。虽然本文中强调的设备具有很大的应用潜力，但还需要更多的数据来了解它们对新生儿结局的影响。
