Optimizing newborn care in the golden hour

Expert insights from Pediatric Tech Watch

Go to section
    Speak to our team

    Evidence-based care pathway for newborns supports emergency resuscitation and family-centered care

    The following article was authored by Vizient-awarded supplier Dräger. It originally appeared in Pediatric Tech Watch, Vol. 10, published November 2023.

    The Golden Minute (first minute after birth) has been identified as a critical window for airway stabilization in a newborn. For preterm newborns, the Golden Minute through the Golden Hour (first 60 minutes after birth) is a critical time, necessitating evidence-based interventions for the best outcomes.

    Timely assessment and intervention during the Golden Hour, including thermoregulation, respiratory support and family-centered care, can lead to fewer complications and better long-term outcomes, especially in newborns who are significantly premature or at extremely low and very low birth weights.1 Applying interventions can prevent injuries that could lead to neurodevelopmental conditions, ushering in long term health challenges for the newborn.

    Dräger is dedicated to lowering morbidity and mortality rates from the first minute of life to discharge — all while reducing stress for newborns, their families and clinical staff. As providers struggle with staffing shortages, they look for additional ways to standardize workflows, reduce variability and deliver effective care. These objectives drive Dräger to develop reliable, standardized solutions to improve critical care in labor and delivery (L&D) and the neonatal intensive care unit (NICU).

    Innovative open care warmer supports NICU team

    The new Dräger Babyroo TN300 open care warming device supports the NICU team as they make regular clinical assessments of the preterm newborn. It offers intuitive features designed to support bedside staff by standardizing set up with settings indicated for premature infants which can be easily adjusted to accommodate each clinical scenario. An optional transport M540 monitor assesses oxygen saturation (SpO2) and monitors heart activity through an electrocardiogram (ECG), aligning with the latest Neonatal Resuscitation Program (NRP) guidelines. The built-in scale with automatic weight adjustments and the ability to weigh the patient while the mattress is tilted ensure correct weight measurements and support workflow efficiencies. Babyroo’s bed tilt indicator can support protocols related to intraventricular hemorrhage (IVH), feeding and development. The Babyroo respiratory support interface requires minimal set up and may help standardize protocols and support resuscitation guidelines for newborns.

    Patient support aligned with standardized pathways

    To better illustrate how the Babyroo TN300’s multiple capabilities function with other advanced Dräger neonatal care solutions, the following is a hypothetical example of preterm care — from the delivery room to the NICU to final discharge.

    Point of care
    Babyroo feature
    Care path
    Action
    Prebirth preparation
    Pre-warm function, intuitive 12 o’clock resuscitation concept
    Maintain a constant core body temperature.2 Provide standardized set up to achieve starting PIP 20, PEEP 5 and FIO2 of 21%.
    Turn on pre-warm function for rapid, safe and effective warming, to help ensure the bed is adequately warmed when newborn arrives.
    Immediately after birth
    Radiant warmer, with optional heated gel mattress
    Keep temperature stable and minimize heat loss.
    Combine these heat sources to deliver uniform heat distribution evenly across entire mattress, even when bed is tilted.
    Immediately after birth
    Large, graphic display panel with configurable screen view for L&D. Includes, APGAR timer, stopwatch and integrated target pre-ductal SpO2 chart
    Quickly assess temperature, ECG HR and SpO2 with M540 monitor.
    Initiate PPV resuscitation, if necessary, using suction and T-piece circuit or manual resuscitation bag to deliver PPV as indicated by the latest NRP guidelines. Use the stopwatch to tag events during resuscitation. These can later be accessed to insure accurate documentation.
    Immediately after birth
    Resuscitation module, with optional AutoBreath functionality
    Maintain all preset ventilation parameters (FiO2, PIP, PEEP) to deliver desired breaths per minute.
    Provide transitional PPV by delivering precise pressures and intervals when using AutoBreath feature (optional).
    Post-stabilization
    Kangaroo mode for skin-to-skin contact
    Maintain observation of newborn’s status during skin-to-skin contact with mom, enabled by continual monitoring and on-screen display of baby’s temperature.
    Record session time, suppress nuisance alarms and maintain temperature settings until baby returns to warmer.

    Abbreviations: FiO2 = fractional concentration of inspired oxygen, IVH = intraventricular hemorrhage, NIV (noninvasive ventilation), NRP = Neonatal Resuscitation Program, PEEP = positive end-expiratory pressure, PIP = peak inspiratory pressure, PPV = positive predictive value, SpO2 = oxygen saturation

    Additional Babyroo capabilities, integrations and options

    • Skin mode — Regulates heating output based on the baby’s skin temperature to allow for precise warming. Babyroo also offers ThermoMonitoring to help detect thermal stress.
    • Jaundice management — Treats jaundice and allows clinicians to seamlessly integrate Babyroo with the BiliLux phototherapy light.
    • Ventilation — Provides ongoing respiratory management with the Babylog neonatal ventilator which provides PPV and NIV options.
    • Limited disruption X-ray — Performs large pass-through X-ray tray imaging without excessive disruption to the newborn.
    • Smart scale with tilt indicator — Allows clinicians to weigh babies even when bed is tilted, while the tilt indicator provides accuracy and visibility of mattress position.
    • Family view screen — Allows parents a bedside view to their baby’s name, current weight and an icon of their choice.
    • Ergonomic newborn access — Supports ergonomic access to the newborn with an easy-to-reach bed area and variable height adjustment, allowing family members and caregivers easy access to the newborn and promoting skin-to-skin contact (kangaroo care) during baby’s NICU stay.
    • AutoThermo package — Helps automate, simplify and support temperature management protocols for hypoxic-ischemic encephalopathy, enabling caregivers to devote more time to the newborn’s care.

    Conclusion

    In the NICU, the Golden Minute through the Golden Hour can present the care team with multiple challenges, including providing optimal care to premature babies to improve long-term outcomes, as well as finding care efficiencies when time is of the essence and understaffing is a factor. Dräger technology, especially the Babyroo TN300, helps the care team provide more consistent, efficient and patient-focused care.

    About the Author

    Dräger holds Vizient supply agreements in several product categories including infant care and phototherapy. View details in Vizient Catalog.

    References

    1. Sharma D. Golden 60minutes of newborn’s life: Part 1: Preterm neonate. J Matern Fetal Neonatal Med. Published 2017 Nov;30(22):2716-2727. doi: 10.1080/14767058.2016.1261398. Epub 2016 Dec 1. PMID: 27844483.
    2. Pereira CB, Heimann K, Czaplik M, et al. Thermoregulation in premature infants: A mathematical model. J Therm Biol. Published 2016 Dec;62(Pt B):159-169. doi: 10.1016/j.jtherbio.2016.06.021. Epub 2016 Jul 5. PMID: 27888930.

    Vizient Pediatric Program

    The Vizient Pediatric Program offers providers expert insights and intelligence backed by data — as well as a highly focused supply portfolio — to help strengthen delivery of high value care for children’s hospitals and pediatric providers. Learn more about our industry-leading performance improvement capabilities on vizientinc.com.

    Access the Vizient Tech Watch page for more data-driven insights and trends affecting healthcare.

    Related Content

    Questions about this topic?

    Share feedback

    Have a question or comment about this article? We’d love to hear from you.

    Call our team

    Contact our support center to connect with a pediatric expert.