Predictors of death including quality of positive pressure ventilation during newborn resuscitation and the relationship to outcome at seven days in a rural Tanzanian hospital

Robert Moshiro, Jeffrey M. Perlman, Hussein Kidanto, Jan Terje Kvaløy, Paschal Mdoe, Hege L. Ersdal, James West
2018 PLoS ONE  
Effective positive pressure ventilation (PPV) of non-breathing newborns is crucial in facilitating cardio-respiratory adaptation at birth. Identifying predictors of death in newborns receiving PPV is important in order to facilitate preventative strategies. Objective The objective of this study was to determine the perinatal predictors of death including the quality of PPV administered among admitted newborns. Methods An observational study of admitted newborns who received PPV after birth was
more » ... PV after birth was conducted. Research assistants observed all deliveries and recorded perinatal events on data collection forms. Measured heart rate (HR) and ventilation parameters were then compared between newborns who died and survivors. Results Newborns (n = 232) were studied between October 2014 and November 2016. Newborns who died (n = 53) compared to survivors (n = 179) had more fetal heart rate (FHRT) abnormalities (12/53 vs 19/179; p = 0.03); lower initial HR (<100 beats/minute) at start of PPV (44/ 48 vs 77/139; p<0.001); and a longer time for HR to increase >100 beats/minute from birth (180 vs 149 seconds; p = 0.07). Newborns who died compared to survivors took longer time (14 vs 4 seconds; p = 0.008) and more inflations (7 vs 3; p = 0.006) to achieve an expired PLOS ONE | https://doi.
doi:10.1371/journal.pone.0202641 pmid:30118519 fatcat:3wko7mohxjgtxkl46mfx474aai