PDF herunterladen
Am J Perinatol
DOI: 10.1055/a-2620-7882
Original Article

Effect of Warmer Height (Standard versus Custom) on Neonatal Chest Compression Performance: A Cross-Over Simulation Study

Authors

  • Tamara Alexander

    1   Neonatal-Perinatal Medicine, Department of Pediatrics, University of Oklahoma Health, Oklahoma City, Oklahoma

  • Lise DeShea 

    1   Neonatal-Perinatal Medicine, Department of Pediatrics, University of Oklahoma Health, Oklahoma City, Oklahoma

  • Leonard W. Wilson Jr.

    2   Department of Rehabilitation Sciences, University of Oklahoma College of Allied Health, Oklahoma City, Oklahoma

  • William H. Beasley 

    3   Developmental and Behavioral Pediatrics, Department of Pediatrics, University of Oklahoma College of Medicine, Oklahoma City, Oklahoma

  • Carol P. Dionne 

    2   Department of Rehabilitation Sciences, University of Oklahoma College of Allied Health, Oklahoma City, Oklahoma

  • Edgardo Szyld 

    4   Neonatal-Perinatal Medicine, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana

  • Birju A. Shah 

    1   Neonatal-Perinatal Medicine, Department of Pediatrics, University of Oklahoma Health, Oklahoma City, Oklahoma

Funding This project was supported in part by the Oklahoma Children's Health Foundation trainee research award.
Weitere Informationen
Auch verfügbar auf
   Lizenzen und Reprints
Preview

Abstract

Objective

This study aimed to evaluate whether a custom warmer height improves the quality and consistency of chest compressions (CCs) compared with a standard warmer height during simulated neonatal resuscitation.

Study Design

Cross-over study using simulated neonatal resuscitation. A controlled research environment equipped with a 12-camera motion capture system, four in-floor multi-axis force plates, a neonatal manikin, and resuscitation equipment. Biomechanical assessments were recorded every 2 minutes during a 20-minute simulation for each condition. Twenty Neonatal Resuscitation Program (NRP)-trained providers. Each participant performed two 20-minute CC sessions—one with the warmer at the standard 100 cm height and one at a custom height selected by the participant. CC depth, force, and rate; participant back angle, heart rate, and self-reported exertion, were analyzed at 2-minute intervals.

Results

Compared with the standard height, the custom height resulted in greater and more consistent CC depth and force while maintaining compression rate. Participants also exhibited a greater back angle, and lower heart rate, and reported reduced exertion under the custom height condition.

Conclusion

Allowing NRP-trained providers to adjust warmer heights led to improved CC quality and consistency, suggesting that customizable warmer heights may enhance neonatal resuscitation performance.

Key Points

  • Custom warmer height chosen by NRP-trained providers resulted in more consistent and greater CC depth and force.

  • It also was associated with less provider fatigue, compared with standard height.

  • During neonatal resuscitation, frontline healthcare professionals changed.

  • Participant heart rate was lower when using the custom versus standard height.

  • Our findings support the need for guidelines on adjusting warmer height during neonatal cardiopulmonary resuscitation.

Keywords

warmer height - fatigue - resuscitation performance - motion technology - ergonomic analysis

Authors' Contributions

B.A.S. and E.S. conceived of and designed the study with advice from C.P.D. C.P.D. and L.W.W. performed the procedures and collected the data. L.D. and W.H.B. analyzed the data. B.A.S., E.S., T.A., L.D., and W.H.B. interpreted the data, and B.A.S., E.S., and T.A. also provided clinical interpretation of the results. B.A.S., E.S., T.A., and L.D. drafted and revised the paper. All authors contributed to the final manuscript and agreed to the published version.


Ethical Approval

This study followed the guidelines of the Declaration of Helsinki. The Institutional Review Board of the University of Oklahoma Health Sciences Center approved the study (approval no.: 9395, April 25, 2022). Written informed consent was obtained from the participants.




Publikationsverlauf

Eingereicht: 27. März 2025

Angenommen: 23. Mai 2025

Artikel online veröffentlicht:
11. Juni 2025

© 2025. Thieme. All rights reserved.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA