Best practices for cardiac monitoring during neonatal resuscitation

To maximize the chances of survival during neonatal resuscitation, rapid assessment of HR is crucial to evaluate neonatal status and guide resuscitation interventions. Underestimating neonatal HR leads to unnecessary life-saving interventions, while overestimating neonatal HR may delay life-saving interventions. Using the most reliable and accurate method of measuring HR is crucial in guiding resuscitation actions during the first minutes of life. The purpose of this manuscript is to provide a review of the current options for HR measurement during neonatal resuscitation, and to highlight strengths and limitations of each method. Well-established methods to assess neonatal HR within the first minutes of life include auscultation, palpation, PO, and ECG. Accuracy of these routine methods varies, with ECG considered as the most reliable and accurate method. Additional technologies that hold promise for the future are also reviewed.