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Heart Rate Assessment Immediately after Birth
Emily Phillipos1, Anne Lee Solevåg, Gerhard Pichler
1Centre for the Studies of Asphyxia and Resuscitation, Royal Alexandra Hospital, Edmonton, Alta., Canada.
Insights
Accurate newborn heart rate monitoring is crucial for resuscitation. Electrocardiography (ECG) is the most accurate method, surpassing palpation and auscultation, while Doppler ultrasound requires further research.
Area of Science:
- Neonatal Medicine
- Medical Device Technology
- Clinical Research
Background:
- Accurate heart rate assessment in newborns immediately after birth is critical for guiding resuscitation efforts.
- Current methods for measuring infant heart rate lack consensus on the optimal approach.
Purpose of the Study:
- To evaluate various heart rate assessment methods in newborn infants at birth.
- To identify the fastest and most accurate method for neonatal heart rate monitoring.
Main Methods:
- Systematic literature search of PubMed, EMBASE, and Google Scholar.
- Included studies evaluated auscultation, palpation, pulse oximetry, electrocardiography, and Doppler ultrasound.
- Keywords included infant, heart rate, monitoring, delivery room, resuscitation, and specific measurement techniques.
Main Results:
- Eighteen studies were reviewed, comparing multiple heart rate assessment techniques.
- Pulse oximetry is more accurate than auscultation and palpation, but its accuracy is debated.
- Electrocardiography (ECG) offers faster and more reliable heart rate readings than pulse oximetry.
- Doppler ultrasound shows promise but requires additional evidence for clinical application.
Conclusions:
- Heart rate assessment in neonates is vital, with varying accuracy among methods.
- Electrocardiography (ECG) is the most accurate method, while palpation and auscultation are least accurate.
- Further research is necessary to establish the clinical utility of Doppler ultrasound for neonatal heart rate monitoring.
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.
Methods:
PubMed, EMBASE and Google Scholar were systematically searched using the following terms: 'infant', 'heart rate', 'monitoring', 'delivery room', 'resuscitation', 'stethoscope', 'auscultation', 'palpation', 'pulse oximetry', 'electrocardiogram', 'Doppler ultrasound', 'photoplethysmography' and 'wearable sensors'.
Results:
Eighteen studies were identified that described various methods of heart rate assessment in newborn infants immediately after birth. Studies examining auscultation, palpation, pulse oximetry, electrocardiography and Doppler ultrasound as ways to measure heart rate were included. Heart rate measurements by pulse oximetry are superior to auscultation and palpation, but there is contradictory evidence about its accuracy depending on whether the sensor is connected to the infant or the oximeter first. Several studies indicate that electrocardiogram provides a reliable heart rate faster than pulse oximetry. Doppler ultrasound shows potential for clinical use, however future evidence is needed to support this conclusion.
Conclusion:
Heart rate assessment is important and there are many measurement methods. The accuracy of routinely applied methods varies, with palpation and auscultation being the least accurate and electrocardiogram being the most accurate. More research is needed on Doppler ultrasound before its clinical use.
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