Background and Objectives

Heart rate (HR) assessment is important during neonatal resuscitation. The most reliable ways of assessing HR at birth are pulse oximetry (PO) and/or electrocardiograph (ECG). However, delayed recording time due to poor perfusion or probe and electrode placement has been a concern. Point-of-care ultrasound (POCUS) provides a real-time instant view of the heart. The aim of this study was to look at the feasibility of POCUS in assessing the heart rate of stable, healthy, term neonates.

Methods

The study was approved by the institutional review board, and informed consent was obtained from the subject’s mother. A real-time video image was obtained from the POCUS probe using the app on the smartphone. The principal investigator (PI) counted the heart beats for six seconds using a stopwatch, which was then multiplied by 10 to give the HR per minute. The assistant recorded the simultaneous HR using the PO. The HRs obtained from both methods were recorded and then compared using the Pearson correlation and Bland-Altman plot.

Results

A total of 30 HR observations were made using the POCUS and PO simultaneously. The correlation coefficient (r) was noted to be 0.75 with a p-value of <0.0001 for pairwise correlation. A strong agreement was noted between the two methods using Bland-Altman Plot.

Conclusion

We were able to demonstrate the feasibility of using handheld POCUS in assessing the HR of stable NB infants in the newborn nursery. A follow-up study is planned to evaluate its feasibility in the delivery room.

中文翻译：

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手持超声评估新生儿心率的可行性

背景和目标

心率 (HR) 评估在新生儿复苏期间很重要。评估出生时 HR 的最可靠方法是脉搏血氧仪 (PO) 和/或心电图 (ECG)。然而，由于灌注不良或探头和电极放置而导致的记录时间延迟一直是一个问题。床旁超声 (POCUS) 提供心脏的实时即时视图。本研究的目的是研究 POCUS 在评估稳定、健康的足月新生儿心率方面的可行性。

方法

该研究得到了机构审查委员会的批准，并获得了受试者母亲的知情同意。使用智能手机上的应用程序从 POCUS 探头获取实时视频图像。首席研究员 (PI) 使用秒表计算心跳 6 秒，然后乘以 10 得出每分钟心率。助理使用 PO 记录同步心率。记录从两种方法获得的 HR，然后使用 Pearson 相关性和 Bland-Altman 图进行比较。

结果

同时使用 POCUS 和 PO 总共进行了 30 次 HR 观察。相关系数 (r) 为 0.75，成对相关的 p 值 <0.0001。使用 Bland-Altman Plot 的两种方法之间有很强的一致性。

结论

我们能够证明使用手持式 POCUS 评估新生儿托儿所稳定 NB 婴儿的 HR 的可行性。计划进行后续研究以评估其在产房中的可行性。