Effect of monitor positioning on visual attention and situation awareness during neonatal resuscitation: a randomised simulation study.

Objectives: To compare situation awareness (SA), visual attention (VA) and protocol adherence in simulated neonatal resuscitations using two different monitor positions.

Design: Randomised controlled simulation study.

Settings: Simulation lab at the Royal Alexandra Hospital, Edmonton, Canada.

The SURV1VE trial-sustained inflation and chest compression versus 3:1 chest compression-to-ventilation ratio during cardiopulmonary resuscitation of asphyxiated newborns: study protocol for a cluster randomized controlled trial.

Background: The need for cardiopulmonary resuscitation (CPR) is often unexpected, and the infrequent use of CPR in the delivery room (DR) limits the opportunity to perform rigorous clinical studies to determine the best method for delivering chest compression (CC) to newborn infants. The current neonatal resuscitation guidelines recommend using a coordinated 3:1 compression-to-ventilation (C:V) ratio (CC at a rate of 90/min and ventilations at a rate of 30/min). In comparison, providing CC during a sustained inflation (SI) (CC + SI) significantly improved hemodynamics, minute ventilation, and time to return of spontaneous circulation (ROSC) compared to 3:1 C:V ratio in asphyxiated piglets.

Ventilation Strategies during Neonatal Cardiopulmonary Resuscitation.

Approximately, 10-20% of newborns require breathing assistance at birth, which remains the cornerstone of neonatal resuscitation. Fortunately, the need for chest compression (CC) or medications in the delivery room (DR) is rare. About 0.

Chest compression during sustained inflation versus 3:1 chest compression:ventilation ratio during neonatal cardiopulmonary resuscitation: a randomised feasibility trial.

Background: Current neonatal resuscitation guidelines recommend 3:1 compression:ventilation (C:V) ratio. Recently, animal studies reported that continuous chest compressions (CC) during a sustained inflation (SI) significantly improved return of spontaneous circulation (ROSC). The approach of CC during SI (CC+SI) has not been examined in the delivery room during neonatal resuscitation.

Analysis of neonatal resuscitation using eye tracking: a pilot study.

Background: Visual attention (VA) is important for situation awareness and decision-making. Eye tracking can be used to analyse the VA of healthcare providers. No study has examined eye tracking during neonatal resuscitation.

Using exhaled CO to guide initial respiratory support at birth: a randomised controlled trial.

Importance: A sustained inflation (SI) provided at birth might reduce bronchopulmonary dysplasia (BPD).

Objective: This study aims to examine whether an SI-guided exhaled carbon dioxide (ECO) compared with positive pressure ventilation (PPV) alone at birth decreases BPD.

Design: Randomised controlled trial.

Impact of Changing Clinical Practices on Early Blood Gas Analyses in Very Preterm Infants and Their Associated Inpatient Outcomes.

Background: Early studies suggest an association of abnormal carbon dioxide (PCO) or oxygen (PO) levels with adverse inpatient outcomes in very preterm babies. Recent resuscitation practice changes, such as targeted oxygen therapy, end-expiratory pressure, and rescue surfactant may influence these associations.

Objective: The aim of this study is to assess the range of the initial partial pressures of PCO and PO in preterm neonates <33 weeks gestational age after birth and their correlation to inpatient neonatal outcomes.

A Novel Prototype Neonatal Resuscitator That Controls Tidal Volume and Ventilation Rate: A Comparative Study of Mask Ventilation in a Newborn Manikin.

The objective of this randomized controlled manikin trial was to examine tidal volume (V) delivery and ventilation rate during mask positive pressure ventilation (PPV) with five different devices, including a volume-controlled prototype Next Step™ device for neonatal resuscitation. We hypothesized that V and rate would be closest to target with the Next Step™. Twenty-five Neonatal Resuscitation Program providers provided mask PPV to a newborn manikin (simulated weight 1 kg) in a randomized order with a self-inflating bag (SIB), a disposable T-piece, a non-disposable T-piece, a stand-alone resuscitation system T-piece, and the Next Step™.

Oxygen Saturation and Heart Rate Ranges in Very Preterm Infants Requiring Respiratory Support at Birth.

Objective: To evaluate the changes in preductal oxygen saturation (SpO) and heart rate in preterm infants receiving continuous positive airway pressure (CPAP) and/or positive-pressure ventilation (PPV) at birth.

Study Design: A prospective observational study at birth of infants aged <32 weeks separated into 2 gestational age (GA) groups: 23-27 weeks (group 1) and 28-31 weeks (group 2). Infants received delayed cord clamping (DCC) in accordance with institutional protocol.

Comparison of positive pressure ventilation devices in a newborn manikin.

Objective: To compare tidal volume (V) delivery and ventilation rate between devices for positive pressure ventilation (PPV) during newborn resuscitation.

Methods: Neonatal resuscitation program providers (n = 25) delivered PPV to a newborn manikin in a randomized order with: a self-inflating bag (SIB), a disposable T-piece, a non-disposable T-piece, a stand-alone infant resuscitation system T-piece and the volume-controlled prototype Next Step device (KM Medical). All T-pieces used a peak inflation pressure of 20cmHO and a 5cmHO positive end-expiratory pressure (PEEP).

Heart Rate Assessment Immediately after Birth.

Background: Heart rate assessment immediately after birth in newborn infants is critical to the correct guidance of resuscitation efforts. There are disagreements as to the best method to measure heart rate.

Objective: The aim of this study was to assess different methods of heart rate assessment in newborn infants at birth to determine the fastest and most accurate method.

Spontaneously Breathing Preterm Infants Change in Tidal Volume to Improve Lung Aeration Immediately after Birth.

Objective: To examine the temporal course of lung aeration at birth in preterm infants <33 weeks gestation.

Study Design: The research team attended deliveries of preterm infants <33 weeks gestation at the Royal Alexandra Hospital. Infants who received only continuous positive airway pressure were eligible for inclusion.

Exhaled carbon dioxide can be used to guide respiratory support in the delivery room.

Unlabelled: Respiratory support in the delivery room remains challenging. Assessing chest rise is imprecise, and mask leak and airway obstruction are common problems. We describe recordings of respiratory signals during delivery room resuscitations and discuss guidance on positive-pressure ventilation using respiratory parameters and exhaled carbon dioxide (ECO2 ) during neonatal resuscitations.