Analyzing video recorded support of postnatal transition in preterm infants following a c-section.

Dimitrios Konstantelos,Jürgen Dinger,Sascha Ifflaender,Mario Rüdiger

doi:10.1186/s12884-016-1045-2

Dimitrios Konstantelos, Jürgen Dinger + Show 2 more

Open Access

https://doi.org/10.1186/s12884-016-1045-2

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Abstract

BackgroundOver the past years, research on neonatal resuscitation has focused on single interventions. The present study was performed to analyze the process quality of delivery room management of preterm infants born by c-section in our institution.MethodsWe performed a cross-sectional study of videos of preterm infants born by c-section. Videos were analyzed according to time point, duration and number of performed medical interventions. The study period occurred between January 2012 and December 2013. Infants were caterogized in 3 groups according to their gestational age.ResultsOne hundred eleven videos were analyzed. 100 (90 %) of the infants were transferred to NICU and 91 (83 %) received respiratory support after a median of 0.5 min. All infants were auscultated after 8 (5–16) seconds median (IQR) and an oxygen saturation sensor was placed after 37 (28–52) seconds. 23 infants were intubated after 9 (6–17) minutes and 17 received exogenous surfactant; 29 % according to INSURE (intubation-surfactant-extubation) technique. The duration of intubation attempts was 47 (25–60) seconds. 51 % of the newborns received a sustained inflation for 8 (6–9) seconds. A successful IV-line placement occurred after 15 (12–20) minutes. 4 % of the infants were transported to the NICU without an IV-line after 3 (difference range: 2–5) unsuccessful attempts.ConclusionsUsing video analysis as a tool to study process quality, we conclude that interventions differ not only between but also within similar age groups. This data can be used for benchmarking with current guidelines and practice in other centers.Electronic supplementary materialThe online version of this article (doi:10.1186/s12884-016-1045-2) contains supplementary material, which is available to authorized users.

Highlights

Over the past years, research on neonatal resuscitation has focused on single interventions
One hundred eleven videos of delivery room (DR)-management in preterm infants born by c-section were analyzed
Videos had a total duration of 2619 min [median of 24 (IQR, 19–29) minutes per video]. 22 different caregivers performed DR-management on these infants with a median frequency of 2 (IQR 1–5) patients per caregiver. 50 videos of low gestational age (LGA), 46 of very low gestational age (VLGA) and 15 of extremely low gestational age (ELGA) infants were analyzed

Summary

Introduction

Research on neonatal resuscitation has focused on single interventions. The present study was performed to analyze the process quality of delivery room management of preterm infants born by c-section in our institution. On immature newborns on whom quality of delivery room (DR) management is of great importance. Research has focused on optimizing postnatal adaptation [1,2,3]. The importance of monitoring – of vital signs and respiratory parameters or body temperature – has been proven in clinical studies [15, 16]. Interventions that have been widely used in the past – such as suctioning of the oropharynx – have been abandoned [17]

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