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Am J Perinatol 2024; 41(S 01): e2485-e2488
DOI: 10.1055/a-2121-8500
Short Communication

Amplification of Heart Sounds Using Digital Stethoscope in Simulation-Based Neonatal Resuscitation

Anirudha Das
1   Department of Neonatology, Cleveland Clinic Children's Hospital, Cleveland, Ohio
,
Kim Adams
1   Department of Neonatology, Cleveland Clinic Children's Hospital, Cleveland, Ohio
,
Shelagh Stoicoiu
1   Department of Neonatology, Cleveland Clinic Children's Hospital, Cleveland, Ohio
,
Shafeeque Kunhiabdullah
2   Department of Neonatology, MetroHealth Medical Center, Cleveland, Ohio
,
Ajith Mathew
1   Department of Neonatology, Cleveland Clinic Children's Hospital, Cleveland, Ohio
› Author Affiliations Funding None.
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Abstract

Objective The accuracy, timeliness, and reliability of the current methods of heart rate (HR) determination in neonatal resuscitation are debatable, each having its own limitations. We aim to compare three methods of HR assessment: (1) traditional stethoscope, (2) electrocardiogram and traditional stethoscope, and (3) digital stethoscope with loudspeaker amplification of heart sounds.

Study Design This was a simulated crossover experiment using a high-fidelity manikin. Each team with a physician, a nurse, and a respiratory therapist performed the resuscitations using the three methods (three different scenarios) in different order. The person controlling the HR via manikin controller was blinded, but the single recorder and the providers were not.

Results Eighteen resuscitations were completed (six teams of three methods each). The time to first HR recording (p < 0.001), total number of HR recorded (p < 0.001), and time to recognize dips in HR was significantly improved in the digital stethoscope group (p = 0.009).

Conclusion Use of digital stethoscope with amplification improved documentation of HR and earlier recognition of HR changes.

Key Points

  • Amplified heartbeats during neonatal resuscitation improved documentation.

  • Amplified infant heartbeats resulted in earlier recognition of HR changes (increase or decrease).

  • Providers using this method had greater satisfaction.

Keywords

digital stethoscope - heart rate amplification - neonatal resuscitation

Authors' Contributions

A.D. conceptualized and designed the study, drafted the initial manuscript, and reviewed and revised the manuscript. K.A., S.K., and S.S. set up the experiment, collected data, and reviewed the manuscript. A.M. was involved in data review, reliability testing, and manuscript review. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.




Publication History

Received: 18 November 2022

Accepted: 28 June 2023

Accepted Manuscript online:
03 July 2023

Article published online:
29 July 2023

© 2023. Thieme. All rights reserved.

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  • References

  • 1 Wyckoff MH, Wyllie J, Aziz K. et al; Neonatal Life Support Collaborators. Neonatal life support 2020 international consensus on cardiopulmonary resuscitation and emergency cardiovascular care science with treatment recommendations. Resuscitation 2020; 156: A156-A187
    CrossrefPubMedSearch in Google Scholar
  • 2 Johnson PA, Schmölzer GM. Heart rate assessment during neonatal resuscitation. Healthcare (Basel) 2020; 8 (01) 43
    CrossrefPubMedSearch in Google Scholar
  • 3 Hodgson KA, Kamlin COF, Rogerson S, Thio M. ECG monitoring in the delivery room is not reliable for all patients. Arch Dis Child Fetal Neonatal Ed 2018; 103 (01) F88
    CrossrefPubMedSearch in Google Scholar
  • 4 Voogdt KG, Morrison AC, Wood FE, van Elburg RM, Wyllie JP. A randomised, simulated study assessing auscultation of heart rate at birth. Resuscitation 2010; 81 (08) 1000-1003
    CrossrefPubMedSearch in Google Scholar
  • 5 Gaertner VD, Kevat AC, Davis PG, Kamlin COF. Evaluation of a digital stethoscope in transitioning term infants after birth. Arch Dis Child Fetal Neonatal Ed 2017; 102 (04) F370-F371
    CrossrefPubMedSearch in Google Scholar
  • 6 Treston BP, Semberova J, Kernan R. et al. Assessment of neonatal heart rate immediately after birth using digital stethoscope, handheld ultrasound and electrocardiography: an observational cohort study. Arch Dis Child Fetal Neonatal Ed 2019; 104 (02) F227
    CrossrefPubMedSearch in Google Scholar
  • 7 Agrawal G, Kumar A, Wazir S. et al. A comparative evaluation of portable Doppler ultrasound versus electrocardiogram in heart-rate accuracy and acquisition time immediately after delivery: a multicenter observational study. J Matern Fetal Neonatal Med 2021; 34 (13) 2053-2060
    CrossrefPubMedSearch in Google Scholar
  • 8 Kayama K, Hosono S, Yoshikawa K. et al. Heart-rate evaluation using fetal ultrasonic Doppler during neonatal resuscitation. Pediatr Int 2020; 62 (08) 926-931
    CrossrefPubMedSearch in Google Scholar