Abstract
Objective The objective of this study was to evaluate chest compression (CC) quality and operator
fatigue during CC, with coordinated ventilation, on a neonatal simulator and to explore
its association with provider aerobic activity and body mass index.
Methods This was a prospective observational experimental study on pediatricians, neonatologists,
and neonatal nurses who frequently deliver newborns and who have signed the informed
consent. Subjects performed CC coordinated with ventilations at a ratio of 3:1 for
10 minutes on a neonatal mannequin. Proxy of fatigue was defined as four consecutive
CC below target.
Results Forty subjects participated; 62% were women. Twenty one (52%) evidenced weariness,
as they performed. No gender-based differences were found in weariness. No subject
abandoned the procedure due to fatigue. Subjects who participated in aerobic exercise
had a significantly better performance than those who did not participate. Early fatigue
was significantly associated with higher BMI. The reduction in effectiveness occurred
at a mean time of 7.7 minutes (range 3.5–9 minutes).
Conclusion CC performance quality decreased and fatigue was frequent before 10 minutes had elapsed
on a neonatal simulator. Provider fatigue was associated with both lack of aerobic
activity and BMI ≥ 25. Our findings support the need for guidelines requiring frequent
rotation of CC providers during prolonged neonatal resuscitation.
Keywords
neonatal resuscitation - chest compression - fatigue - newborn
