Published March 21, 2018
Sara K. Berkelhamer, MD, clinical associate professor of pediatrics, has been awarded a $50,000 grant from the Laerdal Foundation to study resuscitation and heart rate monitoring of infants in the Democratic Republic of Congo.
The study, titled “Heart Rate Instability of Infants Deemed Vigorous at Birth,” is in collaboration with the Kinshasa School of Public Health (KSPH), the project’s partner academic organization.
“While much work has been done to define oxygen saturations of infants at birth, detailed heart rate characterization and the correlation with care during the first five minutes as well as clinical outcomes of infants who are deemed crying and vigorous has not been described,” says Berkelhamer, the principal investigator on the grant.
The KSPH will help with collecting data and observing deliveries at three different hospitals.
“The first phase of our training is planned for late summer — it’s staged training,” says Berkelhamer, who says the first step is to teach resuscitation education and then return for follow-up training with the added use of heart rate monitoring.
“Our study will provide a large body of data about heart rate variability in newborns born in a low-resource setting,” she adds.
Berkelhamer’s research complements research being performed with other colleagues from the American Association of Pediatrics, utilizing a program called Helping Babies Breathe, a low-cost, portable skills-based newborn resuscitation education program.
A key focus of the Laerdal Foundation — which is located in Stavenger, Norway — is funding projects related to saving lives at birth in low-resource settings.
“Laerdal has supported other phases of our program development. We knew it would be a good first start for this work,” Berkelhamer says. “They have a biannual application process and I applied for funding that way.”
NeoBeat, which is trademarked by Laerdal Medical, is a low-cost, portable heartbeat monitor that is applied within seconds and obtains information on the heart rate of a newborn.
“The study provides a unique opportunity to evaluate the presence of heart rate instability by placement of NeoBeat on infants who are deemed vigorous by providers,” says Berkelhamer, who specializes in neonatal-perinatal medicine.
Researchers are also encouraged by the effectiveness of portable bag-mask ventilators that are now available at low cost for use in areas that don’t have access to hospitals.
“The availability of lower-cost, easily distributable equipment is very important — combined with resuscitation education. They go hand in hand. That’s a key part of this program,” Berkelhamer says.
“We’re excited to identify if simple access to heart rate monitoring may assist a single provider in more effective resuscitation. The information may be able to identify newborns who are in trouble earlier or provide important feedback about response to interventions,” Berkelhamer adds. “Continuous heart rate monitoring may result in more appropriate and effective resuscitation of newborn infants. That’s what the grant was about.”
Researchers are also interested in what the techniques and technological advances will mean for health care providers in those settings.
“In many parts of the world, the person who’s on the front line in taking care of babies when they’re born may not have advanced training or a medical degree,” says Berkelhamer, who has mentored health care workers throughout the world. “They’re also going to have the challenge of taking care of a baby and a mom at the same time. Simple access to heart rate monitoring is likely to facilitate their identification of newborns who may need more attention or additional resuscitation.”