Congratulations to Chelsea Morin as she completed her MSc Thesis on "NRP or PALS for Infant CPR"

Chelsea Morin Completes MSc Thesis on "NRP or PALS for Infant Cardiopulmonary Resuscitation"

We are excited to announce that Chelsea Morin has successfully completed her MSc thesis on the critical topic of Infant Cardiopulmonary Resuscitation (CPR). Her research tackles one of the most challenging aspects of neonatal and infant care—how to effectively resuscitate infants in cardiac arrest. While outcomes have improved over the years, there remains substantial room for progress, particularly in developing evidence-based guidelines for CPR in infants

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Background: Challenges in Infant and Neonatal Resuscitation

CPR in neonates and infants is a rare but high-stakes event. Currently, neonates are resuscitated using the 3:1 chest compression-to-ventilation (C:V) ratio, focusing on ventilation due to the fact that asphyxia is the most common cause of cardiac arrest in the delivery room. In older infants,continuous chest compressions with asynchronous ventilations (CCaV)are used once an endotracheal tube is placed. However, there is no consistent guideline for when to transition from neonatal CPR (3:1 C:V) to infant CPR (CCaV), leading to variability in clinical practice.

Morin’s thesis also investigates a novel technique known as chest compression with sustained inflation (CC+SI), which has shown promising results in animal models and neonates by improving survival rates and reducing the duration of resuscitation efforts.

Aims of the Study

Chelsea Morin's thesis aimed to:

1. Compare survival and resuscitation duration between 3:1 C:V

   and CCaV in infant piglet models with severe bradycardia.

2. Compare CCaV and CC+SI to assess whether CC+SI improves outcomes in the same animal model.

3. Evaluate human factors in a neonatal resuscitation simulation comparing CC+SI to standard methods (3:1 C:V or CCaV), focusing on ease of use and cognitive load.

Methodology: Combining Animal Models and Simulation

Morin’s research utilized both animal models and simulation to evaluate resuscitation techniques. Piglets aged 5-10 days were used to simulate infant CPR, with groups randomized to receive either 3:1 C:V, CCaV, or CC+SI. In the simulation study, 20 teams of neonatal healthcare workers participated in two standardized resuscitation scenarios, which were randomized by method. Morin’s team evaluatedcognitive loadusing the NASA Task Load Index (NASA-TLX) andperformanceusing the Ottawa Global Rating Scale (OGRS).

Key Findings

1. 3:1 C:V vs. CCaV:

   
   

   • There was no difference in survival between 3:1 C:V and CCaV in the piglet model (7/10 vs. 6/10, respectively).

   • Duration of resuscitation was also similar, and both methods produced comparable hemodynamic outcomes, though differences in respiratory parameters were observed due to the equipment used in each method.

2. CC+SI vs. CCaV:

   • While survival rates were comparable between CC+SI and CCaV, the duration of resuscitation was significantly shorter with CC+SI, indicating a potential benefit for faster recovery.

   • Respiratory parameters, such as minute ventilation and carbon dioxide clearance, were improved with CC+SI, and intrathoracic pressure was significantly higher during CC+SI, which may enhance resuscitation efficacy.

3. Human Factors Simulation:

   • The simulation revealed that CC+SI was no more cognitively or physically demanding than traditional CPR methods.

   • Although healthcare workers had less experience with CC+SI, they found it easier to perform and better for role-switching and communication, showing its potential for ease of adoption in clinical settings.

Conclusion

Chelsea Morin’s research contributes valuable knowledge to the ongoing debate about the best approach to infant CPR. While survival rates were similar across methods, the CC+SI technique offers significant advantages in reducing the duration of resuscitation and improving respiratory outcomes. Importantly, CC+SI did not increase cognitive or physical demands on healthcare providers, suggesting it could be seamlessly integrated into current practice without adding additional strain.

Further studies are warranted to refine the use of CC+SI and explore its broader application in both neonatal and infant resuscitation. Morin’s work paves the way for future research and development, with the ultimate goal of improving outcomes for infants in critical care situations.

We look forward to seeing how her findings will impact future practices and guidelines in neonatal and pediatric resuscitation.