Comparison of two different monitors (electrocardiogram and pulse oximeter versus pulse oximeter alone) for monitoring heart rate in newly born infants: A randomised study

ISRCTN ISRCTN11028739
DOI https://doi.org/10.1186/ISRCTN11028739
Secondary identifying numbers SHEEP001
Submission date
15/03/2017
Registration date
04/05/2017
Last edited
11/12/2018
Recruitment status
No longer recruiting
Overall study status
Completed
Condition category
Pregnancy and Childbirth
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data

Plain English Summary

Background and study aims
Immediately after birth, a baby's heart rate (HR) is measured to determine if babies need help with their breathing. This was traditionally done using a stethoscope. Over the last ten years, pulse oximeters have increasingly been used to measure HR after birth. Pulse oximeters (PO) are machines which non-invasively measure blood oxygen levels and HR. PO measures HR by counting the number of pulses in the hand. They have been used to monitor infants HR for many years. More recently, electrocardiograms (ECG) have been recommended to measure HR in newly born infants. This method uses sensors to measure HR. For either method, it is important that information is displayed quickly, especially right after birth when it is critical to know if a baby requires help breathing. The National Maternity Hospital (Ireland) current uses PO to measure and monitor HR of a baby right after birth. However, the hospital has machines that combine both ECG and PO that are being used in the neonatal unit (post birth unit). These could be used instead of PO to measure HR right after birth if they are able to quickly measure and monitor HR of babies. The aim of this study is to compare two different heart monitoring machines to see how quickly they are able to provide HR information.

Who can participate?
Babies born at the National Maternity Hospital (Ireland)

What does the study involve?
Newborn babies are randomly allocated to one of two groups. Those in the first group have their HR measured using a monitor that combines both an ECG and a PO. This involves an ECG sensor and a PO monitored placed around their right wrist or hand. Those in the second group have their HR measured only using a PO monitor that is placed around their right wrist or hand. The time taken for each monitor to display the babies HR is recorded and there is no further follow up involved for participants.

What are the possible benefits and risks of participating?
There are no notable benefits or risks with participating.

Where is the study run from?
National Maternity Hospital (Ireland)

When is the study starting and how long is it expected to run for?
February 2017 to June 2017

Who is funding the study?
National Maternity Hospital (Ireland)

Who is the main contact?
Professor Colm O’Donnell

Contact information

Prof Colm O'Donnell
Scientific

Neonatal Unit
National Maternity Hospital
Holles Street
Dublin
D02 YH21
Ireland

ORCiD logoORCID ID 0000-0001-7453-5452

Study information

Study designSingle-centre unmasked randomised parallel group study
Primary study designObservational
Secondary study designRandomised parallel group comparison
Study setting(s)Hospital
Study typeOther
Participant information sheet Not available in web format, please use the contact details below to request a patient information sheet
Scientific titleA randomised study of heart rate estimation comparing two monitors (electrocardiogram plus pulse oximeter versus pulse oximeter alone) in newly-born infants
Study acronymSHEEP
Study hypothesisElectrocardiogram and pulse oximetry gives a heart rate (HR) more quickly than pulse oximetry alone in the first minutes of life.
Ethics approval(s)Research Ethic Committee at the National Maternity Hospital, 06/03/2017, ref: EC04.2017
ConditionDelivery room care of newborn infants
InterventionNewly-born infants are transferred to an open resuscitation cot as practicable after birth. Infants are randomly allocated to one of two groups.

Intervention group: Infants are monitored using the Intellivue X2 monitor (Philips, Eindhoven, Netherlands) which incorporates electrocardiogram (ECG) and pulse oximetry (PO). The infants have the ECG applied before the PO sensor is placed around their right wrist or hand and attached to the machine.

Control group: Infants are monitored with a Nellcor PM1ON portable PO (Covidien, Boulder CO, USA). The PO sensor is placed around the right wrist or hand and then attached to the machine. Infants are observed to ensure that they are well as is standard with any birth.

The time taken for each monitor to display the infants heart rate (HR) is recorded and the infants participation in the study ends at this point and there is no further follow-up. The duration of participation is around five minutes.
Intervention typeOther
Primary outcome measureTime to first heart rate from monitor application measured in seconds using a stopwatch.
Secondary outcome measures1. Failure of monitoring (i.e. heart is not displayed) is measured within 5 minutes of applying the monitor
2. Time taken to apply monitor is measured in seconds using a stopwatch
3. Skin damage with leads/sensors are measured by visual inspection at around five minutes
Overall study start date01/02/2017
Overall study end date30/06/2017

Eligibility

Participant type(s)Patient
Age groupNeonate
SexBoth
Target number of participants100
Participant inclusion criteriaAll infants (term and pre-term) born at National Maternity Hospital.
Participant exclusion criteria1. Major congenital anomalies
2. No antenatal consent
Recruitment start date17/04/2017
Recruitment end date15/06/2017

Locations

Countries of recruitment

  • Ireland

Study participating centre

National Maternity Hospital
Neonatal Unit
Holles Street
Dublin
D02 YH21
Ireland

Sponsor information

National Maternity Hospital
Other

Neonatal Unit
Holles Street
Dublin 2
Dublin
D02 YH21
Ireland

ROR logo "ROR" https://ror.org/03jcxa214

Funders

Funder type

Hospital/treatment centre

National Maternity Hospital

No information available

Results and Publications

Intention to publish date30/06/2018
Individual participant data (IPD) Intention to shareYes
IPD sharing plan summaryOther
Publication and dissemination planPublication and dissemination plan as of 15/10/2018:
Submission of results for presentation at the annual meeting of the European Society for Paediatric Research and Pediatric Academic Societies.
IPD sharing planThe datasets generated and/or analysed during the current study during this study will be included in the subsequent results publication.

Previous publication and dissemination plan:
Submission of results for presentation at the annual meeting of the European Society for Paediatric Research and Pediatric Academic Societies.

IPD sharing plan:
The current data sharing plans for the current study are unknown and will be made available at a later date

Study outputs

Output type Details Date created Date added Peer reviewed? Patient-facing?
Basic results 15/10/2018 15/10/2018 No No
Results article results 01/09/2019 Yes No

Additional files

ISRCTN11028739_BasicResults_15Oct18.pdf
Uploaded 15/10/2018

Editorial Notes

11/12/2018: Publication reference added.
15/10/2018: The following updates were made:
1. The publication and dissemination plan was updated.
2. The participant level data was updated.
3. The basic results of this trial have been uploaded as an additional file.