Comparative accuracy of a wireless heart rate monitor (NeoBeat) versus standard EKG during resuscitation of very premature neonates.

Background: Rapid and accurate heart rate assessment is essential in neonatal resuscitation, particularly for very premature infants where delays can impact timely intervention. A wireless heart rate monitor (NeoBeat) device has been validated in term babies but not in smaller preterm infants. We sought to validate the use of the Neobeat device compared to standard EKG in extremely preterm neonates during resuscitation.

Methods: A prospective observational study of very premature neonates undergoing routine resuscitation was conducted at a tertiary care center. Heart rate data were simultaneously recorded using the NeoBeat wireless monitor and a standard three-lead EKG.

Results: Thirty very preterm infants (gestational age, (GA) 26.6 ± 1.9 weeks and birth weight range (250-1310 g)) were enrolled. A total of 1690 heart rate pairs were analyzed. A strong correlation and tracking observed between NeoBeat and EKG-derived heart rates (Pearson r = 0.96, Spearman ρ = 0.95), with a mean absolute difference of 3.76 beats per minute (bpm). Correlation remained robust across different resuscitation interventions (Intubation: r = 0.93 vs. No Intubation: r = 0.90, p = 0.207, PPV: r = 0.93 vs. No PPV: r = 0.87, p = 0.726).

Conclusion: In very preterm infants, NeoBeat wireless monitor achieved 96 % precision (r = 0.96) and maintained a mean absolute difference of 3.76 bpm compared to EKG, supporting its reliability and accuracy for real time neonatal monitoring, including infants weighing as little as 250 g, though statistical power in this range was limited. Randomized studies comparing NeoBeat to standard EKG are warranted to confirm these findings in extremely preterm infants and explore whether NeoBeat improves clinical outcomes.