Abstract
Advances in neonatal care have resulted in improved outcomes for high-risk newborns with technologies playing a significant part although many were developed for the neonatal intensive care unit. The care provided in the delivery room (DR) during the first few minutes of life can impact short- and long-term neonatal outcomes. Increasingly, technologies have a critical role to play in the DR particularly with monitoring and information provision. However, the DR is a unique environment and has major challenges around the period of foetal to neonatal transition that need to be overcome when developing new technologies. This review focuses on current DR technologies as well as those just emerging and further over the horizon. We identify what key opinion leaders in DR care think of current technologies, what the important DR measures are to them, and which technologies might be useful in the future. We link these with key technologies including respiratory function monitors, electoral impedance tomography, videolaryngoscopy, augmented reality, video recording, eye tracking, artificial intelligence, and contactless monitoring. Encouraging funders and industry to address the unique technological challenges of newborn care in the DR will allow the continued improvement of outcomes of high-risk infants from the moment of birth. IMPACT: Technological advances for newborn delivery room care require consideration of the unique environment, the variable patient characteristics, and disease states, as well as human factor challenges. Neonatology as a speciality has embraced technology, allowing its rapid progression and improved outcomes for infants, although innovation in the delivery room often lags behind that in the intensive care unit. Investing in new and emerging technologies can support healthcare providers when optimising care and could improve training, safety, and neonatal outcomes.
Highlights
Delivery room (DR) management of the newborn focuses on ensuring the physiological process of oxygen delivery transitions from the placenta to the lungs
85% of term babies breathe within 10–30 s and require no support, 10% respond to stimulation or airway opening, and approximately 5% of infants will require positive pressure ventilation (PPV), 0.3% chest compressions, and 0.05% adrenaline.[2]
Adoption barriers include the portability of equipment, evidence of benefit, and the training required for utilisation in high-pressure environments
Summary
Delivery room (DR) management of the newborn focuses on ensuring the physiological process of oxygen delivery transitions from the placenta to the lungs. Respiratory function monitoring Healthcare professionals (HCPs) provide PPV via a mask using a T-piece or self-inflating bag during newborn airway support.[5,12] These devices can generate unknown and variable tidal volumes (VT) depending on mask seal,[30,31] airway obstruction,[32] and EIT has been used to assess lung changes at birth and in other settings including: well infants,[53] post surfactant,[54,55] optimal ventilation strategies,[56] sustained lung inflations,[57,58] assessment for extubation,[59] body positioning,[60] endotracheal tube placement,[61,62] effect of suctioning[63] and pneumothorax identification.[64,65]. Computer vision and AI approaches could significantly speed this process up and even offer real-time feedback of resuscitation progress to support clinical decisionmaking and avoid delays with treatments This could open up the exciting potential to link these data with long-term outcomes creating a digital database for more efficient, big data analyses. Superpixels are clusters of image pixels that are grouped together by their
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