Heart Rate Changes following Facemask Placement in Infants Born at ≥32+0Weeks of Gestation

Shiraz Badurdeen, Elisa Brooijmans, Douglas A. Blank, Kristel Leontina Anne Marie Kuypers, Arjan B. Te Pas, Calum Roberts, Graeme R. Polglase, Stuart B. Hooper, Peter G. Davis

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Introduction: Recent reports have raised concerns of cardiorespiratory deterioration in some infants receiving respiratory support at birth. We aimed to independently determine whether respiratory support with a facemask is associated with a decrease in heart rate (HR) in some late-preterm and term infants. Methods: Secondary analysis of data from infants born at ≥32+0 weeks of gestation at 2 perinatal centres in Melbourne, Australia. Change in HR up to 120 s after facemask placement, measured using 3-lead electrocardiography, was assessed every 3 s until 60 s and every 5 s thereafter from video recordings. Results: In the 15 s after facemask placement, 10/68 (15%) infants had a decrease in mean HR by >10 beats per minute (bpm) compared with their individual baseline mean HR in the 15 s before facemask placement. In 4 (6%) infants, HR decreased to <100 bpm. Nine out of 68 (13%) infants had an increase in mean HR by >10 bpm; 7 of these infants had a baseline HR <120 bpm. In univariable comparisons, the following characteristics were found not to be risk factors for a decrease in HR by >10 bpm: prematurity; type of respiratory support; hypoxaemia; early cord clamping; mode of birth; HR <120 bpm before mask placement. Six out of 63 infants (10%) who had HR ≥120 bpm after facemask placement had a late decrease in HR to <100 bpm between 30 and 120 s after facemask placement. Conclusion: Facemask respiratory support at birth is temporally associated with a decrease in HR in a subset of late-preterm and term infants.

Original languageEnglish
Pages (from-to)624–632
Number of pages9
JournalNeonatology
Volume120
Issue number5
DOIs
Publication statusPublished - 2023

Keywords

  • Bradycardia
  • Heart rate
  • Neonate
  • Resuscitation
  • Trigeminocardiac reflex
  • Ventilation

Cite this