The purpose of this study is to determine whether using electrocardiograms (ECGs) during resuscitation of preterm infants (less than 31 weeks gestation) will decrease the amount of time it takes from birth for heart rate (HR) to be above 100 beats per minute and oxygen saturations to be in the goal range, in other words to stabilize the infant. A few studies have been conducted which showed that ECGs are faster at detecting HR than pulse oximetry (PO). Sample sizes, however, have been small and only few extremely low birthweight infants have been included. It is unclear if use of ECG in these tiny preterm infants in addition to traditional techniques to determine HR will be beneficial and impact resuscitation and outcomes. The investigators propose a study where infants will be randomized to either using ECG in addition to PO ± auscultation versus PO ± auscultation only to assess HR during neonatal resuscitation. The investigators hypothesize that the group of infants randomized to ECG will be able to stabilize faster, i.e. achieve HR \> 100 beats per minute and oxygen saturation in goal range faster.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
OTHER
Masking
NONE
Enrollment
51
Experimental
Control
Parkland Hospital
Dallas, Texas, United States
Time to Infant Stabilization
Amount of time it takes from birth for heart rate to be above 100 beats per minute and oxygen saturation to be in the goal range (per Neonatal Resuscitation Program guidelines)
Time frame: During delivery room resuscitation, up to 1 hour
Time to heart rate >100 beats per minute
Time in delivery room
Time frame: During delivery room resuscitation, up to 1 hour
Time to goal oxygen saturation
Time in delivery room
Time frame: During delivery room resuscitation, up to 1 hour
Time of positive pressure ventilation
Total time positive pressure received in delivery room
Time frame: During delivery room resuscitation, up to 1 hour
Incidence of positive pressure ventilation
Positive pressure ventilation applied in delivery room
Time frame: During delivery room resuscitation, up to 1 hour
Incidence of CPR
CRP applied in delivery room
Time frame: During delivery room resuscitation, up to 1 hour
Incidence of intubation
Intubation in delivery room
Time frame: During delivery room resuscitation, up to 1 hour
Maximum FiO2 applied
FiO2 applied in delivery room
Time frame: During delivery room resuscitation, up to 1 hour
Maximum peak inspiratory pressure
Maximum peak inspiratory pressure in delivery room
Time frame: During delivery room resuscitation, up to 1 hour
Incidence of hypothermia
Hypothermia on admission to NICU
Time frame: Until hospital discharge, up to 6 months
Incidence of need for surfactant
Surfactant given while in NICU
Time frame: Until hospital discharge, up to 6 months
Incidence of bronchopulmonary dysplasia
Incidence in NICU
Time frame: Until hospital discharge, up to 6 months
Incidence of respiratory distress syndrome
Incidence in NICU
Time frame: Until hospital discharge, up to 6 months
Incidence of pneumothorax
Incidence in NICU
Time frame: Until hospital discharge, up to 6 months
Incidence of intraventricular hemorrhage
Incidence in NICU
Time frame: Until hospital discharge, up to 6 months
Incidence of necrotizing enterocolitis
Incidence in NICU
Time frame: Until hospital discharge, up to 6 months
Incidence of sepsis
Incidence in NICU
Time frame: Until hospital discharge, up to 6 months
Incidence of symptomatic PDA
Incidence in NICU
Time frame: Until hospital discharge, up to 6 months
Incidence of appropriate vs inappropriate use of positive pressure ventilation
Use in delivery room
Time frame: During delivery room resuscitation, up to 1 hour
Incidence of equipment failure of pulse oximeter and electrocardiogram
Failure in delivery room
Time frame: During delivery room resuscitation, up to 1 hour
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