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Delivery room ultrasound study to assess heart rate in newborns: DELIROUS study

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Abstract

During neonatal resuscitation in the delivery room, heart rate guides clinical intervention, and although different methods have been evaluated as auscultation, pulse oximetry, and electrocardiography, they have various limitations. This was a prospective observational study which aim was to evaluate the accuracy and speed of ultrasound for measuring neonatal heart rate compared with stethoscope, pulse oximetry, and electrocardiography. Simultaneous determinations of heart rate using stethoscope, ultrasound, pulse oximetry, and electrocardiography were performed. Fifty term newborns were included. There were no differences according to the turn on time of the ultrasound, pulse oximetry, and electrocardiography (p = 0.666), but the placement time and the detection time from birth were shorter for ultrasound (p < 0.001). A stronger positive correlation was detected between ultrasound and electrocardiography at 90 (Rho = 0.926), and 120 s (Rho = 0.920) with p < 0.001. The Bland–Altman analysis showed a bias of − 2.23 (p = 0.129) between ultrasound and electrocardiography at 90 s, and a bias of 0.44 (p = 0.092) at 120 s. Instead, the bias between auscultation and electrocardiography at 90 s was − 6.71 (p = 0.131), and at 120 s was of − 4.67 (p = 0.793).

Conclusions: Ultrasound is a fast method to detect heart rate in the delivery room and has a good correlation with stethoscope and electrocardiography.

What is Known:

• During neonatal resuscitation in the delivery room, heart rate guides clinical intervention, and although different methods have been evaluated, they have various limitations.

What is New:

• Heart rate ultrasound is a good and fast method to detect HR in the delivery room with a good correlation with electrocardiography and stethoscope.

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Abbreviations

HR:

Heart rate

CPR:

Cardiopulmonary resuscitation

PO:

Pulse oximeter

ECG:

Electrocardiography

US:

Ultrasound

PEA:

Pulseless electrical activity

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Acknowledgments

To the newborns and families which accepted to join the study.

Author information

Authors and Affiliations

  1. Disorders of Immunity and Respiration of the Paediatric Critical Patient Research Group, Institut Recerca Hospital Sant Joan de Déu, Universitat de Barcelona, Barcelona, Spain

    S. Bobillo-Perez

  2. Paediatric Intensive Care Unit, Hospital Sant Joan de Déu, Universitat de Barcelona, Barcelona, Spain

    S. Bobillo-Perez, M. Balaguer & I. Jordan

  3. Neonatal Intensive Care Unit, Paediatric Department, Hospital Joan XXIII, Tarragona, Spain

    A. Batista-Muñoz, M. Ramon, O. Otero & C. Sorribes

  4. Neonatal Intensive Care Unit, Paediatric Department, Hospital Germans Trias i Pujol, Badalona, Universitat Autònoma de Barcelona, Carretera deCanyet s/n, 08196. Badalona, Barcelona, Spain

    J. Rodriguez-Fanjul

Authors
  1. S. Bobillo-Perez
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  2. M. Balaguer
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  3. I. Jordan
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  4. A. Batista-Muñoz
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  5. M. Ramon
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  6. O. Otero
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  7. C. Sorribes
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  8. J. Rodriguez-Fanjul
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Contributions

JRF, SBP, ABM, CS, and MR conceived and designed the study. MB, IJ, and SBP analyzed the data. JRF, SBP, MB, and IJ wrote the first draft of the manuscript. RF, ABM, CS, OO, and MR contributed to the writing of the manuscript. All authors agree with the manuscript results and conclusions, jointly developed the structure and arguments for the paper, made critical revisions, and reviewed and approved the final version of the manuscript.

Corresponding author

Correspondence to J. Rodriguez-Fanjul.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This study was approved by the local Ethical Assistance Committee and the institutional review board.

Informed consent

Obtained from all the parents of the participants.

Additional information

Communicated by Daniele De Luca

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Bobillo-Perez, S., Balaguer, M., Jordan, I. et al. Delivery room ultrasound study to assess heart rate in newborns: DELIROUS study. Eur J Pediatr 180, 783–790 (2021). https://doi.org/10.1007/s00431-020-03776-4

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  • DOI: https://doi.org/10.1007/s00431-020-03776-4

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