Functionality and acceptability of a novel non-invasive neonatal heart rate monitoring device: a qualitative study of healthcare professionals

BackgroundDetecting neonatal heart rate rapidly and accurately at birth is essential if resuscitation is required. The Neo-Sense prototype provides a quick, non-invasive method to measure neonatal heart rate at birth based on electric potential sensing technology. The study aimed to inform the prototype design process by exploring the required features and usability of this novel device among healthcare professionals.MethodsFace-to-face, semistructured interviews were conducted with healthcare professionals involved in the immediate care of babies at birth: paediatricians, midwives and neonatal nurses. Interviews were audio-recorded and subsequently transcribed verbatim. Two independent researchers coded and extracted the emerging categories and performed a thematic content analysis.ResultsIn total, 21 participants were interviewed, 7 from each professional group. Participants expressed a positive attitude towards the novel prototype. The three main themes extracted were anticipated limitations, advantages and suggestions for development and usage. Participants preferred a device that is easy to use and attach, one which is positioned in a mattress or pad, maintaining also the option of being mobile. Education was considered to have a key role in addressing staff anxiety. The ideal features most frequently mentioned were speed of assessment, reliability and accuracy.ConclusionsThe study enabled a better understanding of the perceived barriers and facilitators to developing a new heart rate monitoring device. The development of a quick and accurate device would have immense implications for clinical practice and the potential to improve neonatal mortality and morbidity.

Maternal, fetal and neonatal heart rate and heart rate variability in Holstein cattle

ABSTRACT: The aim of this study was to describe the normal values for maternal, fetal and neonatal heart rate (HR) and heart rate variability (HRV) indexes in the time domain (standard deviation of beat-to-beat interval - SDNN; root mean square of successive beat-to-beat differences - RMSSD) and the frequency domain (low frequency - LF; high frequency - HF; relationship between low and high frequency - LF/HF) in 23 Holstein cows, 23 fetuses and 18 neonates during the perinatal period. HR and HRV were calculated by fetomaternal electrocardiography (ECG). Fetomaternal measurements were taken six times prepartum (between days 234 and 279 of pregnancy) and measurements were taken in neonates six times after calving (after birth and five times weekly). HR, time and frequency domain were analyzed. No significant changes in maternal, fetal beat-to-beat interval (RR interval) or HR were found. In maternal variables, SDNN decreased significantly from 38.08±2.6ms (day 14 before calving) to 23.7±2.5ms (day 1 after calving) (p<0.05), but the RMSSD did not change significantly. HR and RR interval of calf differed statistically from the day before delivery (163±7.5bpm; 381±24.2ms) to the day after calving (131±5bpm; 472±16.2ms). Time variables (SDNN and RMSSD) and the frequency-domain variables (LF and HF) were significantly different (p<0.05) between fetal and neonatal stages. Reductions in the values of SDNN and RMSSD can reflect a sympathetic dominance. After calving, the increase in HF and decrease in LF variables can indicate activation of the vagal nerve followed by heart and respiratory modulation.