HeartLight: Heart Rate Monitoring for Newborn Resuscitation

NCT ID: NCT02701920

Last Updated: 2018-05-17

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Total Enrollment

184 participants

Study Classification

OBSERVATIONAL

Study Start Date

2016-03-31

Study Completion Date

2018-05-11

Brief Summary

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This study will compare a newborn heart rate sensor (HeartLight) that is integrated into a hat with other common forms of heart rate monitoring such as electrocardiography (ECG), stethoscope and pulse oximetry (PO) in newborn babies. This will help to evaluate the new heart rate sensor's reliability and accuracy.

Detailed Description

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Up to 10% of newborns require some form of resuscitation at birth. Heart rate (HR) is the most sensitive indicator of resuscitation efficacy. HR is most commonly estimated using a stethoscope. However, in simulation studies it has been shown that newborn healthcare providers estimate HR incorrectly in up to 1/3 of cases. Common techniques for monitoring heart rate such as electrocardiography (ECG) and pulse oximetry (PO) were not developed for resuscitation at birth.

ECG, an established and accurate method of monitoring HR, is rarely used in the delivery room for a number of reasons including difficulty ensuring adhesion to the skin (the baby is wet/covered in vernix) and skin damage in premature babies caused by stripping of the electrodes. Current ECG systems also require 3 electrodes to be positioned which can delay resuscitation further. The usual site for transmission PO is the foot or hand. However, in newborn babies, and particularly those requiring resuscitation when the HR is low, blood flow is reduced so physiological mechanisms preserve brain and heart blood flow at the expense of other less important organs and limbs. As a consequence of this and the choice of wavelengths, it can be more difficult to obtain a reliable HR from POs on the limbs, and they typically obtain an HR after 1-2 minutes.

In the delivery room, ECG and PO systems have a requirement for cables to connect to the main monitors. These can get in the way and it is now recommended for many babies to delay cutting the umbilical cord (to ensure more blood enters the baby from the placenta) which often requires the baby to be resuscitated very close to the mother and even between their legs.

The HeartLight system is a wireless optical sensor within a custom newborn hat to allow quick and accurate HR monitoring. It will be compared to ECG, PO and electronic stethoscope to determine the accuracy and reliability. The trial has 4 phases; Phase 1 evaluates the thermal properties of the hat, Phase 2 evaluates the accuracy and reliability of the HeartLight sensor on babies within the Neonatal Intensive Care Unit environment, Phase 3 evaluates the HeartLight sensor in newborn babies born by cesarean section and Phase 4 evaluates the performance of the HeartLight sensor in babies of all gestations requiring resuscitation and stabilisation at birth.

The investigators anticipate the HeartLight sensor and hat will allow swift and effective deployment, reduce delays in resuscitation (due to using a stethoscope) and improve HR accuracy (as a result of avoiding errors in the usual manual mental calculations made in the stressful environment of the delivery room) when it is needed most. However, an additional benefit is that it will not require significant modification to the existing care pathway or resuscitation protocols, and therefore a potential barrier to clinical uptake is removed.

Conditions

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Infant, Newborn, Diseases Fetus or Neonate Affected by Cesarean Section Infant, Premature, Diseases

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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NICU infants and hat

Newborn infants of any gestation on the neonatal intensive care unit (NICU).

HeartLight hat

Intervention Type DEVICE

HeartLight hat will be worn for up to 1 hour.

The HeartLight hat with in-built sensor

Intervention Type DEVICE

The HeartLight hat with in-built sensor will be worn.

NICU infants and sensor

Newborn infants of any gestation requiring heart rate monitoring on the neonatal intensive care unit.

The HeartLight hat with in-built sensor

Intervention Type DEVICE

The HeartLight hat with in-built sensor will be worn.

HeartLight

Intervention Type DEVICE

Electronic stethoscope will be used to estimate heart rate with HeartLight sensor/hat

HeartLight device

Intervention Type DEVICE

HeartLight sensor/hat will be used with ECG/Pulse oximetry/electronic stethoscope

Newborns and surgical delivery

Well term newborn infants following birth by cesarean section.

The HeartLight hat with in-built sensor

Intervention Type DEVICE

The HeartLight hat with in-built sensor will be worn.

HeartLight

Intervention Type DEVICE

Electronic stethoscope will be used to estimate heart rate with HeartLight sensor/hat

HeartLight device

Intervention Type DEVICE

HeartLight sensor/hat will be used with ECG/Pulse oximetry/electronic stethoscope

Newborns needing stabilisation

Newborn infants requiring resuscitation or stabilisation following birth.

HeartLight

Intervention Type DEVICE

Electronic stethoscope will be used to estimate heart rate with HeartLight sensor/hat

HeartLight device

Intervention Type DEVICE

HeartLight sensor/hat will be used with ECG/Pulse oximetry/electronic stethoscope

Parental feedback

Parental feedback of babies recruited into HeartLight will be sought.

parental feedback

Intervention Type OTHER

Questionnaire

Healthcare provider feedback

Healthcare professionals caring for babies recruited into HeartLight will have their feedback on the device sought.

healthcare provider feedback

Intervention Type OTHER

Questionnaire

Interventions

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HeartLight hat

HeartLight hat will be worn for up to 1 hour.

Intervention Type DEVICE

The HeartLight hat with in-built sensor

The HeartLight hat with in-built sensor will be worn.

Intervention Type DEVICE

HeartLight

Electronic stethoscope will be used to estimate heart rate with HeartLight sensor/hat

Intervention Type DEVICE

HeartLight device

HeartLight sensor/hat will be used with ECG/Pulse oximetry/electronic stethoscope

Intervention Type DEVICE

parental feedback

Questionnaire

Intervention Type OTHER

healthcare provider feedback

Questionnaire

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Written consent from the mother
* Realistic prospect of survival as determined by the attending clinical team

Phase 1:

\- Infants on NICU

Phase 2:

\- Infants on NICU requiring heart rate monitoring

Phase 3:

\- Newborn infants following non-emergency elective cesarean section

Phase 4:

\- Newborn infants who attending clinical team anticipate will require assessment of heart rate at time of birth

Feedback:

* Mothers of babies recruited into HeartLight study
* Healthcare professionals exposed to the new device

Exclusion Criteria

Phase 1+2:

* Infants undergoing palliative care
* Infants too sick to tolerate additional procedures

Phase 3:

* Abnormal antenatal scans suggesting significant fetal abnormality (by definition these are not routine pregnancies).
* Any infant in whom resuscitation is likely to be required.
* If multiple births then only the first baby born shall be recruited (due to resource limitations with researchers attending the birth)

Phase 4:

* Infants \<23 weeks
* Infants that are not for active resuscitation as decided by the clinical team
* If multiple births then only the first baby born shall be recruited (due to resource limitations with researchers attending the birth)

Feedback:

Unable to obtain written informed consent
Maximum Eligible Age

4 Months

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Heartlight Systems Limited

INDUSTRY

Sponsor Role collaborator

University of Nottingham

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Don Sharkey, PhD

Role: PRINCIPAL_INVESTIGATOR

University of Nottingham

Locations

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University of Nottingham NHS Trust

Nottingham, , United Kingdom

Site Status

Countries

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United Kingdom

Other Identifiers

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15099

Identifier Type: -

Identifier Source: org_study_id

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