Ashwin Ramanathan1, Faezeh Marzbanrad2, Kenneth Tan1,3,4, Fatema-Tuz Zohra2, Mathieu Acchiardi2,5, Robert Roseby1,6, Ajay Kevat1, Atul Malhotra7,8,9. 1. Department of Paediatrics, Monash University, Melbourne, Australia. 2. Department of Electrical and Computer Systems Engineering, Monash University, Melbourne, Australia. 3. Monash Newborn, Monash Children's Hospital, Melbourne, Australia. 4. The Ritchie Centre, Hudson Institute of Medical Research, Melbourne, Australia. 5. Bordeaux Institute of Technology (Bordeaux INP), Talence, France. 6. Department of Paediatric Respiratory Medicine, Monash Children's Hospital, Melbourne, Australia. 7. Department of Paediatrics, Monash University, Melbourne, Australia. atul.malhotra@monash.edu. 8. Monash Newborn, Monash Children's Hospital, Melbourne, Australia. atul.malhotra@monash.edu. 9. The Ritchie Centre, Hudson Institute of Medical Research, Melbourne, Australia. atul.malhotra@monash.edu.
Abstract
Newborn transition is a phase of complex change involving lung fluid clearance and lung aeration. We aimed to use a digital stethoscope (DS) to assess the change in breath sound characteristics over the first 2 h of life and its relationship to mode of delivery. A commercially available DS was used to record breath sounds of term newborns at 1-min and 2-h post-delivery via normal vaginal delivery (NVD) or elective caesarean section (CS). Sound analysis was conducted, and two comparisons were carried out: change in frequency profiles over 2 h, and effect of delivery mode. There was a significant drop in the frequency profile of breath sounds from 1 min to 2 h with mean (SD) frequency decreasing from 333.74 (35.42) to 302.71 (47.19) Hz, p < 0.001, and proportion of power (SD) in the lowest frequency band increasing from 0.27 (0.11) to 0.37 (0.15), p < 0.001. At 1 min, NVD infants had slightly higher frequency than CS but no difference at 2 h. Conclusion: We were able to use DS technology in the transitioning infant to depict significant changes to breath sound characteristics over the first 2 h of life, reflecting the process of lung aeration.What is Known:• Lung fluid clearance and lung aeration are critical processes that facilitate respiration and mode of delivery can impact this• Digital stethoscopes offer enhanced auscultation and have been used in the paediatric population for the assessment of pulmonary and cardiac soundsWhat is New:• This is the first study to use digital stethoscope technology to assess breath sounds at birth• We describe a change in breath sound characteristics over the first 2 h of life and suggest a predictive utility of this analysis to predict the development of respiratory distress in newborns prior to the onset of symptoms.
Newborn transition is a phase of complex change involving lung fluid clearance and lung aeration. We aimed to use a digital stethoscope (DS) to assess the change in breath sound characteristics over the first 2 h of life and its relationship to mode of delivery. A commercially available DS was used to record breath sounds of term newborns at 1-min and 2-h post-delivery via normal vaginal delivery (NVD) or elective caesarean section (CS). Sound analysis was conducted, and two comparisons were carried out: change in frequency profiles over 2 h, and effect of delivery mode. There was a significant drop in the frequency profile of breath sounds from 1 min to 2 h with mean (SD) frequency decreasing from 333.74 (35.42) to 302.71 (47.19) Hz, p < 0.001, and proportion of power (SD) in the lowest frequency band increasing from 0.27 (0.11) to 0.37 (0.15), p < 0.001. At 1 min, NVD infants had slightly higher frequency than CS but no difference at 2 h. Conclusion: We were able to use DS technology in the transitioning infant to depict significant changes to breath sound characteristics over the first 2 h of life, reflecting the process of lung aeration.What is Known:• Lung fluid clearance and lung aeration are critical processes that facilitate respiration and mode of delivery can impact this• Digital stethoscopes offer enhanced auscultation and have been used in the paediatric population for the assessment of pulmonary and cardiac soundsWhat is New:• This is the first study to use digital stethoscope technology to assess breath sounds at birth• We describe a change in breath sound characteristics over the first 2 h of life and suggest a predictive utility of this analysis to predict the development of respiratory distress in newborns prior to the onset of symptoms.
Authors: Natalie Batey; Caroline Henry; Shalabh Garg; Michael Wagner; Atul Malhotra; Michel Valstar; Thomas Smith; Don Sharkey Journal: Pediatr Res Date: 2022-03-03 Impact factor: 3.756