Conference abstract

NeoTapLS: a mHealth tool for assessing heart rate during neonatal resuscitation in low resource settings

Pan African Medical Journal - Conference Proceedings. 2018:9(39).21 Dec 2018.
doi: 10.11604/pamj-cp.2018.9.39.766

Contact the corresponding author
Keywords: Heart rate, mobile health, monitoring, neonatal, resuscitation
Oral presentation

NeoTapLS: a mHealth tool for assessing heart rate during neonatal resuscitation in low resource settings

Nicolas Pejovic1,&, Susanna Myrnerts Höök1, Frances Lubulwa2, Jolly Nankunda3, Tobias Alfvén4, Thorkild Tylleskär1

1Department of Public Health and Primary Care, Centre for International Health, University of Bergen, Bergen, Norway, 2Department of Anesthesia, Mulago National Referral Hospital, Kampala, Uganda, 3Department of Pediatrics and Child Health, Mulago National Referral Hospital, Kampala, Uganda, 4Department of Public Health Sciences, Global Health Systems and Policy, Karolinska Institutet, Stockholm, Sweden

&Corresponding author
Nicolas Pejovic, Department of Public Health and Primary Care, Centre for International Health, University of Bergen, Bergen, Norway

Abstract

Introduction: in 2017, approximately one million babies will die from birth asphyxia in low income settings. Smartphones are available at a low cost even in remote rural areas. Accurate and fast assessment of heart rate (HR) is crucial in neonatal resuscitation. The NeoTapLS project (www.tap4life.org) developed a mHealth system downloadable for free worldwide, targeted at less-experienced users in scarcely equipped delivery units. NeoTapLS necessitates no probes on the baby and includes an Apgar timer and a pacer regulating ventilation. The interface is visible through a latex glove protecting the phone. The aim of the study was to compare the time to obtain HR and the sensitivity of HR assessment using NeoTapLS compared to pulse oximetry (PO).

Methods: an observational study on 51 newborns was conducted at the labor ward theatre, Mulago Hospital, Uganda. 41 of 51 cases were video recorded. The PO was attached to the baby by a neonatologist directly after birth and a pediatric resident assessed HR using NeoTapLS. HR and acquisition time, by NeoTapLS and PO, was obtained in all cases.

Results: a total of 99 paired HR assessments were performed. The acquisition time was significantly lower with NeoTapLS, mean 6 seconds (95% C.I. 5.6 - 6.4s), min 3s max. 20s, compared to pulse oximetry, mean 62s (95% C.I. 51.1 - 75.0s), min. 15s max. 140s, p < 0.001. NeoTap LS indicated a HR with a higher average of 3.6 beats per minute compared to PO.

Conclusion: accurate HR in newborns can be recorded using NeoTapLS, in a low resource setting. The small difference in HR estimate by NeoTapLS compared to PO was not considered to be of clinical relevance. Acquisition time was shorter for NeoTapLS, enabling faster assessment of resuscitation efforts. Further studies need to determine if NeoTapLS is reliable in the hands of less experienced users.