Heart Rate Detection during Resuucitation to Reduce Early Neonatal Mortality

描述（由申请人提供）：该申请提供证据，证明首席和高级外国研究员在全球网络中有主要成就的既定记录，包括设计、实施和发表单站点和通用方案研究和临床试验。在接下来的5年周期中，提出了一项严格设计的多中心随机对照临床试验，该试验旨在创新使用低成本和简单的心率检测器来指导低收入国家初级保健机构使用标准的美国儿科学会帮助婴儿呼吸协议的新生儿复苏，以确定其在降低早期（7天）新生儿死亡率方面的有效性。心率检测器将帮助助产士确定心率。5%到10%的新生儿在出生时没有呼吸或哭泣，而且对助产士来说，很难确定心率和其他生命迹象。对于活着出生的婴儿，心率加快是有效复苏的最佳指标。心率评估

DESCRIPTION (provided by applicant): This application provides evidence that the Principal and Senior Foreign Investigators have an established record of major accomplishments in the Global Network including the design, implementation, and publication of single site and common protocol studies and clinical trials. For the next 5 year cycle, a rigorously-designed multicenter cluster randomized controlled clinical trial of the innovative use of a low cost and simple heart rate detector to guide neonatal resuscitation in primary care settings in low-income countries using the standard American Academy of Pediatrics Helping Babies Breathe protocol is proposed to determine its effectiveness in reducing early (7-day) neonatal mortality. The heart rate detector will assist birth attendants to determine the heart rate. Five to 10 percent of newborn infants appear lifeless at birth without breathing or crying, and determination of the heart rate and other signs of life is difficult for the birth attendants. For infants born alive, a increasing heart rate is the best indicator of an effective resuscitation. Assessment of heart rate changes is difficult to periderm with the usual clinical assessments in the field, and thus many infants die soon after birth. Neonatal resuscitation skills can be guided by heart rate detection even if a feeble heart rate is detected. If effective, electronic heart rate detection may be a breakthrough for deliveries by low- and middle-skilled birth attendants. The proposed team of investigators has collaborated for over 10 years and will continue to work with the NICHD and other sites of the Global Network to design, implement, analyze, and report innovative randomized trials and observational studies that are likely to reduce mortality and morbidities of mothers and infants. The qualifications and unequivocal commitment of the investigators the Zambian staff, as well as the full endorsement of the Government of Zambia, University Teaching Hospital (Zambia), University of Zambia, and the University of Alabama at Birmingham will ensure superior performance if this site is granted participation in the Network. The long-term objective is to improve local health care systems with education, training, implementation, and sustainability of programs to decrease neonatal mortality with the goal of long-term reduction in mortality and morbidity of infants.