• Resuscitation · Apr 2024

    Observational Study

    Newborn resuscitation timelines: accurately capturing treatment in the delivery room.

    • Hanne Pike, Vilde Kolstad, Joar Eilevstjønn, Peter G Davis, Hege Langli Ersdal, and Siren Rettedal.
    • Faculty of Health Sciences, University of Stavanger, Stavanger, Norway; Department of Pediatrics, Stavanger University Hospital, Stavanger, Norway.
    • Resuscitation. 2024 Apr 1; 197: 110156110156.

    ObjectivesTo evaluate the use of newborn resuscitation timelines to assess the incidence, sequence, timing, duration of and response to resuscitative interventions.MethodsA population-based observational study conducted June 2019-November 2021 at Stavanger University Hospital, Norway. Parents consented to participation antenatally. Newborns ≥28 weeks' gestation receiving positive pressure ventilation (PPV) at birth were enrolled. Time of birth was registered. Dry-electrode electrocardiogram was applied as soon as possible after birth and used to measure heart rate continuously during resuscitation. Newborn resuscitation timelines were generated from analysis of video recordings.ResultsOf 7466 newborns ≥28 weeks' gestation, 289 (3.9%) received PPV. Of these, 182 had the resuscitation captured on video, and were included. Two-thirds were apnoeic, and one-third were breathing ineffectively at the commencement of PPV. PPV was started at median (quartiles) 72 (44, 141) seconds after birth and continued for 135 (68, 236) seconds. The ventilation fraction, defined as the proportion of time from first to last inflation during which PPV was provided, was 85%. Interruption in ventilation was most frequently caused by mask repositioning and auscultation. Suctioning was performed in 35% of newborns, in 95% of cases after the initiation of PPV. PPV was commenced within 60 s of birth in 49% of apnoeic and 12% of ineffectively breathing newborns, respectively.ConclusionsNewborn resuscitation timelines can graphically present accurate, time-sensitive and complex data from resuscitations synchronised in time. Timelines can be used to enhance understanding of resuscitation events in data-guided quality improvement initiatives.Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.

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