Heart Rate Detection during Resuucitation to Reduce Early Neonatal Mortality

复苏期间的心率检测可降低新生儿早期死亡率

• 批准号: 9315906
• 负责人: WALDEMAR A. CARLO FONT
• 金额: $ 67.73万
• 依托单位: UNIVERSITY OF ALABAMA AT BIRMINGHAM
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-05-03 至 2018-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9315906
• 关键词: Academy; Address; Alabama; American; Appointment; Asphyxia Neonatorum; Awareness; Birth; Birth Weight; Breathing; Cessation of life; Clinical Trials; Clinical assessments; Communities; Country; Crying; Detection; Effectiveness; Ensure; Goals; Government; Grant; Health; Healthcare Systems; Heart Rate; Infant; Intervention; Life; Low Birth Weight Infant; Measures; Midwife; Morbidity - disease rate; Mothers; National Institute of Child Health and Human Development; Neonatal; Neonatal Mortality; Newborn Infant; Observational Study; Outcome; Pediatrics; Periderm; Physicians; Pregnant Women; Premature Infant; Program Sustainability; Protocols documentation; Publications; Randomized Controlled Clinical Trials; Relative Risks; Reporting; Research Personnel; Resuscitation; Risk Reduction; Site; Subgroup; Teaching Hospitals; Techniques; Testing; Traditional Birth Attendants; Training; Training and Education; Universities; Work; Zambia; adverse outcome; base; cost; data registry; design; detector; improved; infant morbidity; innovation; intrapartum; low income country; meetings; member; mortality; neonatal resuscitation; neonate; performance site; prenatal; primary care setting; public health relevance; randomized trial; rate of change; skills

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.

描述（由申请人提供）：本申请提供证据证明首席和高级外国研究者在全球网络中取得了重大成就，包括设计、实施和发布单中心和共同方案研究及临床试验。在接下来的 5 年周期中，建议开展一项严格设计的多中心集群随机对照临床试验，创新性地使用低成本、简单的心率检测器来指导低收入国家初级保健机构中的新生儿复苏，并使用标准的美国儿科学会帮助婴儿呼吸方案，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。百分之五到百分之十的新生儿在出生时显得毫无生气，没有呼吸或哭闹，并且对助产士来说确定心率和其他生命体征很困难。对于活产婴儿来说，心率增加是有效复苏的最佳指标。心率评估 通过现场通常的临床评估很难发现这种变化，因此许多婴儿在出生后很快就死亡。即使检测到微弱的心率，也可以通过心率检测来指导新生儿复苏技能。如果有效的话，电子心率检测可能会成为中低技能助产士分娩的一个突破。拟议的研究团队已经合作了 10 多年，并将继续与 NICHD 和全球网络的其他站点合作，设计、实施、分析和报告可能降低母亲和婴儿死亡率和发病率的创新随机试验和观察性研究。调查人员和赞比亚工作人员的资格和明确承诺，以及赞比亚政府、大学教学医院（赞比亚）、赞比亚大学和阿拉巴马大学伯明翰分校的充分认可，将确保如果该站点获准参与该网络，其卓越的性能。长期目标是通过教育、培训、实施和可持续性项目来改善当地医疗保健系统，以降低新生儿死亡率，从而长期降低婴儿死亡率和发病率。