Article Text

PDF
Outcome of babies with no detectable heart rate before 10 minutes of age, and the effect of gestation
  1. Thomas Sproat,
  2. Richard Hearn,
  3. Sundeep Harigopal
    1. Neonatal Unit, Royal Victoria Infirmary, Newcastle Upon Tyne, UK
    1. Correspondence to Dr Thomas Sproat, Neonatal Unit, Royal Victoria Infirmary, Richardson Road, Newcastle Upon Tyne, NE1 4LP, UK; tsproat{at}nhs.net telephone

    Abstract

    Objective Current resuscitation guidelines suggest that it is reasonable to consider stopping resuscitation where no heart rate (cardiac activity) has been detected for 10 min in a newborn baby from birth. We aimed to determine the mortality rate and 2-year neurodevelopmental outcome of all babies born with no heart rate before 10 min of age where resuscitation was attempted in a tertiary referral centre over a 5-year period.

    Design To identify all babies with no heart rate before age 10 min we examined two groups:

    ▸ All babies classified as live born who received cardiac massage at birth between January 2009 and December 2013.

    ▸ All babies classified as stillborn between January 2009 and December 2013 where attempts were made at resuscitation beyond 10 min.

    Results 87 babies received cardiac massage. 81 babies were live born and 6 were classified as stillborn. Twenty-two babies had no heart rate before 10 min of age. Eight babies survived to 2-year follow-up. 6/11 term babies survived, 2/4 babies born between 32 weeks and 37 weeks survived, and no infants born less than 32 weeks survived (n=7). Of the survivors, 5/8 had a normal neurodevelopmental outcome at 2 years' age. One patient was lost to follow-up, while the other two patients had hemiplegia.

    Conclusions Our results add to the body of evidence suggesting that having no heart rate before 10 min of age, in term babies, may not be an appropriate prompt to discontinue resuscitation.

    Statistics from Altmetric.com

    Footnotes

    • Correction notice This paper has been amended since it was published Online First. Table 1 and the first paragraph under ‘Outcome: neurodevelopmental’ originally contained identifiable patient information has been replaced with figure 1.

    • Collaborators Paul Ayuk.

    • Contributors RH, SH and TS contributed to the design of the work. TS was responsible for data collection, interpretation and drafting of the work. RH and SH reviewed and gave final approval for submission.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    Request permissions

    If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.