Otsuka Hiroki, Hirakawa Eiji, Yara Asataro, Saito Daisuke, Tokuhisa Takuya
Department of Neonatology, Perinatal Medical Center, Kagoshima City Hospital, Kagoshima, Japan.
Department of Pediatrics, Gifu University Graduate School of Medicine, Gifu, Japan.
Resusc Plus. 2024 Nov 2;20:100811. doi: 10.1016/j.resplu.2024.100811. eCollection 2024 Dec.
High-risk deliveries are still common due to the increased use of assisted reproductive technologies. In Japan, despite centralization of labor, about half of all deliveries are still carried out in obstetric clinics. Telemedicine support is important for neonatal resuscitation involving urgent, life-altering professional judgment in local deliveries. This feasibility study examined the effects of using medical communication software on the quality of neonatal resuscitation, and the physiological parameters of the newborn and stress of the resuscitators.
This observational study included cesarean births with ≥ 36 weeks gestational age at Kagoshima City Hospital between January 1, 2023 and 2024. A camera on the neonatal resuscitation table allowed a neonatologist to observe the resuscitation through a medical communication software and give instructions to the resuscitators. The midwife performing the resuscitation wore a communication microphone to interact with the neonatologist. Details of the neonatal resuscitation procedures, newborn physical findings, and neonatal intensive care unit (NICU) admission rates were collected from medical records. A midwife questionnaire was also administered. The primary endpoints were resuscitation findings, and the secondary endpoint was resuscitator stress before and after implementing the software.
The intervention had no major adverse effects and no change in NICU admission rates; however, there were increases in post-resuscitation temperature and suctioning frequency. While the intervention caused stress to the resuscitators, it also contributed to an increased sense of security and learning.
Telemedicine support in neonatal resuscitation can be introduced without significant adverse effects.
由于辅助生殖技术使用的增加，高危分娩仍然很常见。在日本，尽管分娩已集中化，但仍有大约一半的分娩是在产科诊所进行的。远程医疗支持对于在当地分娩中涉及紧急、改变生命的专业判断的新生儿复苏非常重要。这项可行性研究考察了使用医疗通信软件对新生儿复苏质量、新生儿生理参数以及复苏人员压力的影响。
这项观察性研究纳入了2023年1月1日至2024年期间在鹿儿岛市医院进行的孕周≥36周的剖宫产。新生儿复苏台上的摄像头使新生儿科医生能够通过医疗通信软件观察复苏情况，并向复苏人员发出指示。进行复苏的助产士佩戴通信麦克风与新生儿科医生互动。从医疗记录中收集新生儿复苏程序的详细信息、新生儿身体检查结果以及新生儿重症监护病房（NICU）收治率。还对助产士进行了问卷调查。主要终点是复苏结果，次要终点是实施该软件前后复苏人员的压力。
该干预措施没有重大不良影响，NICU收治率也没有变化；然而，复苏后体温和吸痰频率有所增加。虽然该干预措施给复苏人员带来了压力，但也增强了他们的安全感和学习效果。
可以引入新生儿复苏的远程医疗支持，且不会产生重大不良影响。
