Analyzing video recorded support of postnatal transition in preterm infants following a c-section.

BACKGROUND: Over the past years, research on neonatal resuscitation has focused on single interventions. The present study was performed to analyze the process quality of delivery room management of preterm infants born by c-section in our institution.

METHODS: We performed a cross-sectional study of videos of preterm infants born by c-section. Videos were analyzed according to time point, duration and number of performed medical interventions. The study period occurred between January 2012 and December 2013. Infants were caterogized in 3 groups according to their gestational age.

RESULTS: One hundred eleven videos were analyzed. 100 (90 %) of the infants were transferred to NICU and 91 (83 %) received respiratory support after a median of 0.5 min. All infants were auscultated after 8 (5-16) seconds median (IQR) and an oxygen saturation sensor was placed after 37 (28-52) seconds. 23 infants were intubated after 9 (6-17) minutes and 17 received exogenous surfactant; 29 % according to INSURE (intubation-surfactant-extubation) technique. The duration of intubation attempts was 47 (25-60) seconds. 51 % of the newborns received a sustained inflation for 8 (6-9) seconds. A successful IV-line placement occurred after 15 (12-20) minutes. 4 % of the infants were transported to the NICU without an IV-line after 3 (difference range: 2-5) unsuccessful attempts.

CONCLUSIONS: Using video analysis as a tool to study process quality, we conclude that interventions differ not only between but also within similar age groups. This data can be used for benchmarking with current guidelines and practice in other centers.