Doppler Ultrasound for Heart Rate Assessment in a Porcine Model of Neonatal Asphyxia
Objectives: Approximately 10% of newborn infants require resuscitation at birth. Accurate heart rate (HR) assessment guides resuscitation interventions, thereby reducing morbidities and mortality. While existing HR assessment methods have several limitations, the Doppler ultrasound (Doppler-US) migh...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2020-01-01
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| Series: | Frontiers in Pediatrics |
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| Online Access: | https://www.frontiersin.org/article/10.3389/fped.2020.00018/full |
| _version_ | 1811277245447143424 |
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| author | Nicolò Morina Nicolò Morina Peter A. Johnson Peter A. Johnson Peter A. Johnson Megan O'Reilly Megan O'Reilly Tze-Fun Lee Tze-Fun Lee Maryna Yaskina Po-Yin Cheung Po-Yin Cheung Georg M. Schmölzer Georg M. Schmölzer |
| author_facet | Nicolò Morina Nicolò Morina Peter A. Johnson Peter A. Johnson Peter A. Johnson Megan O'Reilly Megan O'Reilly Tze-Fun Lee Tze-Fun Lee Maryna Yaskina Po-Yin Cheung Po-Yin Cheung Georg M. Schmölzer Georg M. Schmölzer |
| author_sort | Nicolò Morina |
| collection | DOAJ |
| description | Objectives: Approximately 10% of newborn infants require resuscitation at birth. Accurate heart rate (HR) assessment guides resuscitation interventions, thereby reducing morbidities and mortality. While existing HR assessment methods have several limitations, the Doppler ultrasound (Doppler-US) might be a promising alternative. We aimed to evaluate accuracy and optimal use of Doppler-US for HR assessments during neonatal asphyxia in a pre-clinical model.Design: HR assessments were performed in 16 term newborn piglets that were anesthetized, intubated, and instrumented. Study I evaluated optimal transducer position, Study II compared aortic (AV) and pulmonary (PV) examination modes, and Study III examined accuracy during asphyxia, for HR assessment.Setting: Experimental setting.Subjects: Asphyxia-induced piglets.Interventions: Study I: Doppler-US (USCOM® 1A) HR was assessed on upper (A), middle (B), and lower (C) third of the sternum; study II: Doppler-US HR was assessed using AV and PV examination modes; study III: HR was assessed during asphyxia. Comparisons were made between Doppler-US and the clinical gold standard for HR assessments, electrocardiography (ECG).Measurements and Main Results: Study I: Mean (SD) Doppler-US HR at position A, B, and C showed no difference when compared to ECG HR. Study II: The mean (SD) Doppler-US HR using AV and PV modes also showed no difference when compared to ECG HR. Study III: Bland-Altman analysis revealed a mean difference (95% limits of agreement) between Doppler-US and ECG HR of 1.5 (−16 to 19) bpm. Additionally, motion artifacts produced false peaks and peak size was seen to decrease as bradycardia progressed.Conclusions: HR assessment using Doppler-US during asphyxia is accurate but has limitations and must be further evaluated prior to clinical use. Doppler-US can be positioned along the sternum and use either AV or PV mode for accurate assessments in a piglet model of neonatal asphyxia. |
| first_indexed | 2024-04-13T00:12:10Z |
| format | Article |
| id | doaj.art-35185be309fc498594a6e61e30351207 |
| institution | Directory Open Access Journal |
| issn | 2296-2360 |
| language | English |
| last_indexed | 2024-04-13T00:12:10Z |
| publishDate | 2020-01-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Pediatrics |
| spelling | doaj.art-35185be309fc498594a6e61e303512072022-12-22T03:11:02ZengFrontiers Media S.A.Frontiers in Pediatrics2296-23602020-01-01810.3389/fped.2020.00018503638Doppler Ultrasound for Heart Rate Assessment in a Porcine Model of Neonatal AsphyxiaNicolò Morina0Nicolò Morina1Peter A. Johnson2Peter A. Johnson3Peter A. Johnson4Megan O'Reilly5Megan O'Reilly6Tze-Fun Lee7Tze-Fun Lee8Maryna Yaskina9Po-Yin Cheung10Po-Yin Cheung11Georg M. Schmölzer12Georg M. Schmölzer13Centre for the Studies of Asphyxia and Resuscitation, Neonatal Research Unit, Royal Alexandra Hospital, Edmonton, AB, CanadaDepartment of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, CanadaCentre for the Studies of Asphyxia and Resuscitation, Neonatal Research Unit, Royal Alexandra Hospital, Edmonton, AB, CanadaDepartment of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, CanadaWomen and Children's Health Research Institute (WCHRI), University of Alberta, Edmonton, AB, CanadaCentre for the Studies of Asphyxia and Resuscitation, Neonatal Research Unit, Royal Alexandra Hospital, Edmonton, AB, CanadaDepartment of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, CanadaCentre for the Studies of Asphyxia and Resuscitation, Neonatal Research Unit, Royal Alexandra Hospital, Edmonton, AB, CanadaDepartment of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, CanadaWomen and Children's Health Research Institute (WCHRI), University of Alberta, Edmonton, AB, CanadaCentre for the Studies of Asphyxia and Resuscitation, Neonatal Research Unit, Royal Alexandra Hospital, Edmonton, AB, CanadaDepartment of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, CanadaCentre for the Studies of Asphyxia and Resuscitation, Neonatal Research Unit, Royal Alexandra Hospital, Edmonton, AB, CanadaDepartment of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, CanadaObjectives: Approximately 10% of newborn infants require resuscitation at birth. Accurate heart rate (HR) assessment guides resuscitation interventions, thereby reducing morbidities and mortality. While existing HR assessment methods have several limitations, the Doppler ultrasound (Doppler-US) might be a promising alternative. We aimed to evaluate accuracy and optimal use of Doppler-US for HR assessments during neonatal asphyxia in a pre-clinical model.Design: HR assessments were performed in 16 term newborn piglets that were anesthetized, intubated, and instrumented. Study I evaluated optimal transducer position, Study II compared aortic (AV) and pulmonary (PV) examination modes, and Study III examined accuracy during asphyxia, for HR assessment.Setting: Experimental setting.Subjects: Asphyxia-induced piglets.Interventions: Study I: Doppler-US (USCOM® 1A) HR was assessed on upper (A), middle (B), and lower (C) third of the sternum; study II: Doppler-US HR was assessed using AV and PV examination modes; study III: HR was assessed during asphyxia. Comparisons were made between Doppler-US and the clinical gold standard for HR assessments, electrocardiography (ECG).Measurements and Main Results: Study I: Mean (SD) Doppler-US HR at position A, B, and C showed no difference when compared to ECG HR. Study II: The mean (SD) Doppler-US HR using AV and PV modes also showed no difference when compared to ECG HR. Study III: Bland-Altman analysis revealed a mean difference (95% limits of agreement) between Doppler-US and ECG HR of 1.5 (−16 to 19) bpm. Additionally, motion artifacts produced false peaks and peak size was seen to decrease as bradycardia progressed.Conclusions: HR assessment using Doppler-US during asphyxia is accurate but has limitations and must be further evaluated prior to clinical use. Doppler-US can be positioned along the sternum and use either AV or PV mode for accurate assessments in a piglet model of neonatal asphyxia.https://www.frontiersin.org/article/10.3389/fped.2020.00018/fullinfantsnewbornneonatal resuscitationheart rateDoppler ultrasound |
| spellingShingle | Nicolò Morina Nicolò Morina Peter A. Johnson Peter A. Johnson Peter A. Johnson Megan O'Reilly Megan O'Reilly Tze-Fun Lee Tze-Fun Lee Maryna Yaskina Po-Yin Cheung Po-Yin Cheung Georg M. Schmölzer Georg M. Schmölzer Doppler Ultrasound for Heart Rate Assessment in a Porcine Model of Neonatal Asphyxia Frontiers in Pediatrics infants newborn neonatal resuscitation heart rate Doppler ultrasound |
| title | Doppler Ultrasound for Heart Rate Assessment in a Porcine Model of Neonatal Asphyxia |
| title_full | Doppler Ultrasound for Heart Rate Assessment in a Porcine Model of Neonatal Asphyxia |
| title_fullStr | Doppler Ultrasound for Heart Rate Assessment in a Porcine Model of Neonatal Asphyxia |
| title_full_unstemmed | Doppler Ultrasound for Heart Rate Assessment in a Porcine Model of Neonatal Asphyxia |
| title_short | Doppler Ultrasound for Heart Rate Assessment in a Porcine Model of Neonatal Asphyxia |
| title_sort | doppler ultrasound for heart rate assessment in a porcine model of neonatal asphyxia |
| topic | infants newborn neonatal resuscitation heart rate Doppler ultrasound |
| url | https://www.frontiersin.org/article/10.3389/fped.2020.00018/full |
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