Development and testing of an intact cord resuscitation trolley

Abstract

Objective To develop a mobile resuscitation platform—intact cord resuscitation (ICR) trolley and to assess the safety, feasibility and acceptability of its use during delayed cord clamping (DCC). Study design Bench-side product development and single-arm experimental study. Participants and methods We first developed a theoretical framework of the specifications required for the platform which can provide resuscitation close to the delivery/operating table. The theoretical framework was then translated into a working model in a series of iterations. After testing and training of healthcare workers in a simulated environment, the trolley was tested to perform DCC in neonates who were born at ≥34 weeks of gestation and were breathing spontaneously at birth. Outcomes measured Primary outcome was the feasibility of DCC using the ICR trolley defined as the proportion of babies successfully completing 180 s of DCC on the trolley. Secondary outcomes included the proportion of babies with 1 min heart rate (HR) and oxygen saturation (SpO2) recorded, neonatal and maternal safety outcomes, and acceptability among care providers. Results Among 50 neonates (gestation: 36.9±1.9 weeks and birth weight: 2544±649 g) enrolled in the study, DCC for ≥180 s was successfully done in 42 (84%) neonates. The mean duration of DCC was 170±27 s. HR and SpO2 at 1 min were recorded successfully in 92% of the babies. The majority of the maternal and neonatal care provider strongly supported the use of ICR trolley. Conclusion We developed an ICR trolley and successfully tested the feasibility and acceptability of its use in healthy neonates undergoing DCC.