Evaluation of a novel technology for newborn resuscitation: A visual display of time since birth, video–audio recording, and ergonomic resuscitation equipment: A prospective observational design

Objective: Despite advancements in technologies, the quality of intrapartum care has consistently not improved. This study evaluates the potential efficacy of a novel technology for newborn resuscitation, which provides a visual display of time since birth, video-audio recording, and ergonomic resuscitation equipment, on healthcare providers' performance during ventilation in Nepal. Method: This study utilized a prospective observational design conducted over 3 years at a referral hospital in Nepal. All infants who did not cry within 30 seconds of birth were included, and their ventilation performance was assessed across two phases: SUSTAIN (baseline phase) and Pre-MALA (pilot implementation phase). Ventilation performance was measured through direct observation and video annotation, with the median time to first ventilation compared between the two phases using the Mann-Whitney U test and generalized linear mixed model regression. Results: A total of 164 newborn ventilation events were observed, with 78 during the SUSTAIN phase and 86 during Pre-MALA phase. Direct observation was done in both phases, while video-recording annotation was also conducted during Pre-MALA phase. The median time to first ventilation significantly decreased from 84.3 seconds (interquartile range (IQR): 55.4-114.0) during SUSTAIN to 48.2 seconds (IQR: 33.5-85.0) during Pre-MALA (p < 0.001). The duration of suctioning before ventilation was reduced by 17.8 seconds (adjusted coefficient = -17.8; 95% CI; -23.1, -11.8) and time to first ventilation was reduced by 33 seconds (adjusted coefficient = -33.2; 95% CI; -51.1, -15.4) during Pre-MALA. Conclusion: The result suggests that novel technology during resuscitation can reduce time to first ventilation and unnecessary suctioning in a clinical setting. Further large-scale evaluations are needed to fully assess the potential impact on neonatal care.