Publications by authors named "Siren Rettedal"

Deprivation of oxygen in an infant during and after birth leads to birth asphyxia, which is considered one of the leading causes of death in the neonatal period. Adequate resuscitation activities are performed immediately after birth to save the majority of newborns. The primary resuscitation activities include ventilation, stimulation, drying, suction, and chest compression.

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Introduction: Newborn resuscitation algorithms emphasize that resuscitation is time-critical, and all algorithm steps are related to the time of birth. Infrared thermal video has the potential to capture events in the delivery room, such as birth, cord clamping, and resuscitative interventions, while upholding the privacy of patients and healthcare providers.

Objectives: The objectives of this concept study were to (i) investigate the technical feasibility of using thermal video in the delivery room to detect birth and cord clamping, and (ii) evaluate the accuracy of manual real-time registrations of the time of birth and cord clamping by comparing it with the accuracy of registrations abstracted from thermal videos.

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Article Synopsis
  • - The study focuses on improving facemask ventilation in neonatal resuscitation through training, finding that a novel neonatal simulator led to high competence levels in healthcare providers throughout a 9-month period.
  • - Researchers conducted a prospective observational study, examining simulation cases and skill elements while analyzing data to determine the best training frequency and dose for maintaining high ventilation competence.
  • - Results indicate that conducting 5 or more training sessions within the 9 months significantly predicted high overall competence scores, with specific frequencies enhancing performance in certain skills, suggesting the need for tailored training schedules.
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Article Synopsis
  • The study evaluated the effectiveness of newborn resuscitation timelines to track the incidence and response to resuscitation methods after birth, focusing on newborns receiving positive pressure ventilation (PPV).
  • Conducted at Stavanger University Hospital, the study analyzed 289 infants, noting that PPV was typically started around 72 seconds after birth, with a significant fraction of the infants being apneic or breathing ineffectively.
  • The results indicate that the use of these timelines can provide valuable insights for improving resuscitation practices by presenting complex data in an easily understandable format.
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Importance: Good-quality parent-infant interactions have protective effects on infant socio-emotional and behavioral development. These interactions are especially critical for very preterm infants at risk of vulnerabilities related to immaturity. Skin-to-skin contact (SSC) has been found to improve mother-preterm infant interaction behaviors, but few studies exist regarding its benefits when initiated immediately after birth.

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Objective: To determine the prevalence of bradycardia in the first minute after birth and association with positive pressure ventilation (PPV).

Method: A population-based cross-sectional study was conducted from June 2019 to December 2021 at Stavanger University Hospital, Norway. Parents consented to participation during pregnancy, and newborns ≥28 weeks' gestation were included at birth.

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Background: European guidelines recommend the use of pulse oximetry (PO) during newborn resuscitation, especially when there is a need for positive pressure ventilation or supplemental oxygen. The objective was to evaluate (i) to what extent PO was used, (ii) the time and resources spent on the application of PO, and (iii) the proportion of time with a useful PO signal during newborn resuscitation.

Methods: A prospective observational study was conducted at Stavanger University Hospital, Norway, between 6 June 2019 and 16 November 2021.

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Background: Newborn resuscitation guidelines recommend positive pressure ventilation (PPV) for newborns who do not establish effective spontaneous breathing after birth. T-piece resuscitator systems are commonly used in high-resource settings and can additionally provide positive end-expiratory pressure (PEEP). Short expiratory time, high resistance, rapid dynamic changes in lung compliance and large tidal volumes increase the possibility of incomplete exhalation.

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Article Synopsis
  • * It evaluates the incidence of sepsis and bacterial profiles in two groups: those receiving iKMC from birth and those receiving conventional care with delayed KMC.
  • * Results show a significant reduction in suspected sepsis rates among neonates in the iKMC group, especially in those with lower birth weights, indicating that immediate care can enhance health outcomes for vulnerable infants.
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sequence type (ST) 17 is a global problem clone that causes multidrug-resistant (MDR) hospital infections worldwide. In 2008-2009, an outbreak of MDR ST17 occurred at a neonatal intensive care unit (NICU) in Stavanger, Norway. Fifty-seven children were colonized.

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Aim: To investigate the safety of skin-to-skin contact initiated immediately after birth on cardiorespiratory parameters in unstable low birth weight infants.

Methods: A randomized clinical trial was conducted in tertiary newborn units in Ghana, India, Malawi, Nigeria and Tanzania in 2017-2020, in infants with birth weight 1.0-1.

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Objective: The objective was to explore whether high workloads in neonatal intensive care units were associated with short-term respiratory outcomes of extremely premature (EP) infants born <26 weeks of gestational age.

Methods: This was a population-based study using data from the Norwegian Neonatal Network supplemented by data extracted from the medical records of EP infants <26 weeks GA born from 2013 to 2018. To describe the unit workloads, measurements of daily patient volume and unit acuity at each NICU were used.

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Introduction: 3%-8% of newborns need positive pressure ventilation (PPV) after birth. Heart rate (HR) is considered the most sensitive indicator of the newborns' condition and response to resuscitative interventions. According to guidelines, HR should be assessed and PPV initiated within 60 s after birth in non-breathing newborns.

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Aim: 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.

Methods: 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.

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Aim: To investigate the impact of immediate skin-to-skin contact with a parent after birth on thermal regulation in very preterm infants.

Methods: This clinical trial was conducted in three neonatal intensive care units in Scandinavia from 2018 to 2021. Infants born between 28 + 0 and 32 + 6 weeks and days of gestation were randomised to immediate skin-to-skin contact or conventional care in an incubator during the first 6 postnatal hours.

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Objective: The aim of the study was to investigate first extubation attempts among extremely premature (EP) infants and to explore factors that may increase the quality of clinical judgement of extubation readiness.

Design And Method: A population-based study was conducted to explore first extubation attempts for EP infants born before a gestational age (GA) of 26 weeks in Norway between 1 January 2013 and 31 December 2018. Eligible infants were identified via the Norwegian Neonatal Network database.

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Aim: Our aim was to investigate what effect immediate skin-to-skin contact with a parent had on the cardiorespiratory stabilisation of very preterm infants.

Methods: This randomised clinical trial was conducted during 2018-2021 at two university hospitals with three neonatal intensive care units in Norway and Sweden. Infants born from 28+0 to 32+6 weeks of gestation were randomised to immediate skin-to-skin contact with a parent for the first six postnatal hours or standard incubator care.

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Positive pressure ventilation of the non-breathing newborn is a critical and time-sensitive intervention, considered to be the cornerstone of resuscitation. Many healthcare providers working in delivery units in high-resource settings have little opportunity to practise this skill in real life, affecting their performance when called upon to resuscitate a newborn. Low-dose, high-frequency simulation training has shown promise in low-resource settings, improving ventilation performance and changing practice in the clinical situation.

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Background: Assessment of heart rate (HR) is essential during newborn resuscitation, and comparison of dry-electrode ECG technology to standard monitoring by 3-lead ECG and Pulse Oximetry (PO) is lacking.

Methods: NeoBeat, ECG, and PO were applied to newborns resuscitated at birth. Resuscitations were video recorded, and HR was registered every second.

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Aim: T-piece resuscitators are commonly used for respiratory support during newborn resuscitation. This study aimed to describe delivered pressures and tidal volumes when resuscitating term newborns immediately after birth, using the NeoPuff T-piece resuscitator.

Method: Observational study from June 2019 through March 2021 at Stavanger University Hospital, Norway, including term newborns ventilated with a T-piece resuscitator after birth, with consent to participate.

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Face mask ventilation of apnoeic neonates is an essential skill. However, many non-paediatric healthcare personnel (HCP) in high-resource childbirth facilities receive little hands-on real-life practice. Simulation training aims to bridge this gap by enabling skill acquisition and maintenance.

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Importance: Establishing stable breathing is a key event for preterm infants after birth. Delivery of pressure-stable continuous positive airway pressure and avoiding face mask use could be of importance in the delivery room.

Objective: To determine whether using a new respiratory support system with low imposed work of breathing and short binasal prongs decreases delivery room intubations or death compared with a standard T-piece system with a face mask.

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Background: "Kangaroo mother care," a type of newborn care involving skin-to-skin contact with the mother or other caregiver, reduces mortality in infants with low birth weight (<2.0 kg) when initiated after stabilization, but the majority of deaths occur before stabilization. The safety and efficacy of kangaroo mother care initiated soon after birth among infants with low birth weight are uncertain.

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Objective: To compare the accuracy of heart rate detection properties of a novel, wireless, dry-electrode electrocardiogram (ECG) device, NeoBeat®, to that of a conventional 3-lead gel-electrode ECG monitor (PropaqM®) in newborns.

Results: The study population had a mean gestational age of 39 weeks and 2 days (1.5 weeks) and birth weight 3528 g (668 g).

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