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Am J Perinatol 2018; 35(08): 796-800
DOI: 10.1055/s-0037-1620231
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Fatigue during Chest Compression Using a Neonatal Patient Simulator

Diego Enriquez
1   SIMMER Simulación Médica Roemmers (SIMMER), Buenos Aires, Olivos, Argentina
,
Javier Meritano
2   Department of Neonatology, Ramón Sardá Maternity Hospital, CABA, Argentina
,
Birju A. Shah
3   Department of Pediatrics, OUHSC-University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
,
Clara Song
3   Department of Pediatrics, OUHSC-University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
,
Edgardo Szyld
3   Department of Pediatrics, OUHSC-University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
› Author Affiliations
Further Information

Publication History

31 October 2017

07 December 2017

Publication Date:
10 January 2018 (online)

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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