Kibsgaard Amalie, Ersdal Hege, Kvaløy Jan Terje, Eilevstjønn Joar, Rettedal Siren
Department of Paediatrics, Stavanger University Hospital, Stavanger, Norway.
Faculty of Health Sciences, University of Stavanger, Stavanger, Norway.
Acta Paediatr. 2023 Apr;112(4):697-705. doi: 10.1111/apa.16659. Epub 2023 Jan 21.
The aim was to study the prevalence of bradycardia at birth in newborns requiring positive pressure ventilation (PPV), distribution of first measured heart rate (HR), changes in HR before start of PPV and HR response to PPV.
A population-based study including newborns ≥30 weeks' gestation receiving PPV at birth. HR was captured immediately after birth and continuously throughout resuscitation using the dry-electrode ECG device NeoBeat. Time of birth was registered in the Liveborn app. Provision of PPV was captured by video.
We included 98 newborns receiving PPV at birth. Among newborns with HR measured within 60 s after birth, median (quartiles) first HR was 112 (84, 149) bpm recorded 19 (14, 37) s after birth, of which 33% had first HR <100 and 10% had first HR <60 bpm respectively. First HR was widely distributed. Median HR at start PPV 69 s after birth was 129 bpm. In newborns with an initial low HR, HR typically remained low for 20 s of PPV before increasing rapidly over the next 20-30 s.
First measured HR was ≥100 bpm in two thirds of newborns receiving PPV. In bradycardic infants, HR did not increase until after 20 s of PPV.
本研究旨在探讨需要正压通气（PPV）的新生儿出生时心动过缓的患病率、首次测量心率（HR）的分布情况、PPV开始前HR的变化以及HR对PPV的反应。
一项基于人群的研究，纳入出生时接受PPV且孕周≥30周的新生儿。出生后立即使用干电极心电图设备NeoBeat捕捉HR，并在整个复苏过程中持续监测。出生时间在Liveborn应用程序中记录。PPV的实施情况通过视频记录。
我们纳入了98例出生时接受PPV的新生儿。在出生后60秒内测量HR的新生儿中，出生后19（14，37）秒记录的首次HR中位数（四分位数）为112（84，149）次/分钟，其中分别有33%的新生儿首次HR<100次/分钟，10%的新生儿首次HR<60次/分钟。首次HR分布广泛。出生后69秒开始PPV时的HR中位数为129次/分钟。在初始HR较低的新生儿中，HR通常在PPV的前20秒保持较低水平，然后在接下来的20 - 30秒内迅速上升。
在接受PPV的新生儿中三分之二首次测量的HR≥100次/分钟。在心动过缓的婴儿中，HR直到PPV 20秒后才增加。
