Neo One Solution

For some, life begins with a need for specialized acute care following impaired oxygenation, acid-base disturbances or other events. The care that a newborn receives in the first hours and days has a significant impact on short- and long-term outcomes

Radiometer supports healthcare professionals with a unique solution that helps you provide the best possible care to those that are the most vulnerable – in the delivery room and in the neonatal intensive care unit.

A complete picture at every step

The NeoOne solution includes specialized blood gas analyzers, safe sampling devices and continuous, non-invasive transcutaneous monitoring systems. This combination of advanced technologies gives you access to quick, complete and accurate information about the neonate's condition.

Such information provides the best foundation for documenting and securing quality of care during labor, at birth and throughout the first stages of a neonate's life.

Fetal scalp blood sampling

Fetal well-being depends on an adequate supply of oxygen from maternal circulation. A number of conditions can compromise oxygen delivery to the fetus inside the womb. Lack of oxygen can negatively affect the fetus’ health condition after birth in both the short and long term.

If intrapartum hypoxia is severe and prolonged, it can result in asphyxia, which is a metabolic acidosis caused by deprivation of oxygen. Asphyxia can lead to permanent brain damage or, in severe cases, even death [1].

The World Health Organization (WHO) estimates that between 4 and 9 million newborns globally suffer from asphyxia each year, leading to an estimated 1.2 million deaths and more than a million infants developing severe disabilities. WHO also estimates that 29% of global neonatal deaths are caused by birth asphyxia [2].

Fetal scalp blood sampling is considered a useful fetal monitoring tool by expert bodies to prevent neonatal morbidity and mortality.

• When is fetal scalp blood sampling indicated?
• Which parameters are important to measure: pH, lactate or both?
• Why is sample volume important?
• What is the best fetal scalp sampling technique?
• How can medical professionals ensure fast turnaround time?
• What do your national guidelines indicate and how do they compare to guidelines around the world?

Get the answers in Chris Higgins’ article ‘Fetal scalp blood sampling’, published on acutecaretesting.org or go to the site to subscribe for more clinical and scientific news.

Improving outcomes with the NeoOne solution

In the delivery room, fetal scalp blood testing is performed to assess, with high specificity, birth asphyxia as a consequence of impaired oxygenation. This condition is a threat to the fetus and may require immediate intervention [3].

Radiometer’s unique NeoOne solution, which includes the advanced ABL90 FLEX PLUS blood gas analyzer and safeCLINITUBESplastic capillary tubes, provides immediate results on critical parameters such as pH and lactate from a very small sample volume, optimizing the safety of both mother and fetus.

Fast results from a 45 µL blood sample means medical decisions can be made quickly

Obtaining sufficient blood from the fetal scalp can be a challenge. With Radiometer’s ABL90 FLEX PLUS blood gas analyzer only 45 µL of blood is required to run a sample. Analyzing a capillary blood sample on the ABL90 FLEX PLUS analyzer is done in a simple 2-step process – and the results are available in just 60 seconds.

Radiometer’s safeCLINITUBES plastic capillary tubes are pre-heparinized with high-concentration sodium heparin to prevent the blood sample from clotting. The safeCLINITUBES are designed to reinforce the capillary actions of the tube to enable fast and easy filling.

Cord blood sampling

The pH, pCO2 and base excess from the cord arteries provide valuable objective evidence of the metabolic condition of neonates at the moment of delivery, which has assured a role for the blood gas analyzer in the hospital’s delivery rooms and obstetrics clinics.

The World Health Organization (WHO) estimates that between 4 and 9 million newborns globally suffer from asphyxia each year, leading to an estimated 1.2 million deaths and more than a million infants developing severe disabilities. WHO also estimates that 29% of global neonatal deaths are caused by birth asphyxia [2].

Cord blood sampling can be performed to quickly determine whether a neonate is suffering from asphyxia and which subsequent measures should be taken.

• What is the clinical relevance of the determination of the acid-base values of the cord blood of the newborn, and what are acceptable values?
• How and when should the sample be collected?
• Why should you collect a blood sample from both a cord artery and the cord vein?
• Which parameters are important to measure: pH, pCO2, base excess, lactate...?
• Should cord blood gas analysis be reserved for selected neonates or should it be applied for all neonates?
• What is the value of cord blood gas on record for all neonates in case of litigation?
• What do your national guidelines indicate and how do they compare to guidelines around the world?

Get the answers in Chris Higgins’ article ‘Umbilical-cord blood gas analysis’ published on acutecaretesting.org.

Improving outcomes with the NeoOne solution

Immediately after birth, cord blood gas testing is performed to determine the acid-base status of the neonate at the moment of delivery in order to detect birth asphyxia. The cord blood gas result can also be used to document quality of care [4] and can prove to be important documentation in case of litigation [5].

Radiometer’s unique NeoOne solution, which includes the advanced ABL90 FLEX PLUS blood gas analyzer and safePICO arterial blood gas syringes, provides fast and accurate results on critical parameters for the assessment of the neonate.

Proven measuring performance means reliable results

Accurate test results on cord blood samples are critical for making well-informed medical assessments of the neonate’s wellbeing.

Radiometer’s ABL90 FLEX PLUS blood gas analyzer is a state-of-the art analyzer offering a wealth of automated functionalities. The measuring performance of the ABL90 FLEX analyzer series is well proven and backed by solid evidence.

The integrated sample mixer on the ABL90 FLEX PLUS analyzer enables fast and effective mixing of safePICO arterial blood gas syringes. That helps obtain a homogeneous and clot-free sample, which is a pre-requisite for accurate test results and a well-functioning analyzer.

Blood gas surveillance of the neonate

In the NICU, at-risk neonates require close surveillance. Undetected changes in blood gas levels may result in severe damage to a neonate’s health and should be acted upon immediately.

Blood gas sampling is the most common test performed [6]. But neonates do not have sufficient blood volume to tolerate multiple sample collections. A justification for testing is needed [7].

Preterm neonates are particularly vulnerable to alterations in arterial oxygen, carbon dioxide and haemodynamics. Unsafe levels or high fluctuations in pO2 and pCO2 can harm their immature and fragile organs:

• Brain perfusion is impacted by abnormal blood gas concentrations
• Uncontrolled pO2 increases can lead to hyperoxia and a risk of retinopathy of prematurity
• A sudden increase in the pCO2 value is a sign of a change in the cardio-respiratory status of the neonate or a sign of complication

So what is the best way to cater for fragile neonates?

• Reduce the number of sporadic blood collections?
• Determine the right moment to collect a blood sample?
• Find the best way to quickly diagnose significant respiratory problems?
• Trend pCO2 continuously?

Get answers to some of these questions from hospitals around the world, where transcutaneous monitoring and blood gas testing have successfully been implemented.

Improving outcomes with the NeoOne solution

Radiometer’s unique NeoOne solution, which combines transcutaneous monitoring, specialized blood gas analysis and safe sampling devices, empowers you to make well-informed treatment decisions, while reducing the collection of precious blood from fragile neonates.

Our TCM CombiM transcutaneous monitor provides continuous, non-invasive and real-time monitoring of the neonate and helps schedule and potentially reduce the number of blood gas samples [8, 9].

When blood sampling is needed, our safeCLINITUBES plastic capillary tubes and ABL90 FLEX PLUS blood gas analyzer offer fast and easy sampling for a full panel of critical parameters (blood gases, glucose, lactate, hemoglobin, bilirubin, etc.) from a very small sample volume.

See the change as it happens with real-time transcutaneous monitoring

Radiometer’s TCM CombiM monitor represents a valuable transcutaneous trending tool that provides continuous, non-invasive and real-time transcutaneous pO2 and pCO2 information.

The differentiating feature of the TCM CombiM system is the pO2measurement, a crucial parameter when monitoring patients in neonatal intensive care. A pO2 measurement helps lower the risk of hyperoxia and severe complications, such as retinopathy of prematurity (ROP).

With continuous, real-time information you can see the change in blood gas levels as it happens and can take immediate action. As a result, neonate safety and comfort are improved.

From the smallest drop of blood

Our new and advanced ABL90 FLEX PLUS blood gas analyzer is designed to meet the needs of neonatal care. Its special micromode measurement provides 17 critical parameters from the smallest sample volume in just 60 seconds when used with our new 45 µL safeCLINITUBES plastic capillary tubes. This means greater focus on neonate safety and comfort.

References

1. Higgins C. Fetal scalp blood sampling. www.acutecaretesting.org. Dec 2014.
2. Omo-Aghoja L. Maternal and fetal acid-base chemistry: a major determinant of perinatal outcome. Ann Med Health Sci Res 2014; 4,1: 8–17.
3. Kenyon S et al. Intrapartum care: Care of healthy women and their babies during childbirth. London: RCOG Press; 2007.
4. Perinatal Safety Programme – a quality project in all maternity wards in Denmark] Sikre fødsler – et kvalitetsprojekt på alle fødeafdelinger I Danmark.http://www.regioner.dk/sundhed/kvalitet/patientsikkerhed/sikre+fødsler. Accessed 2014-10-10
5. Boog, G. [Cerebral palsy and perinatal asphyxia (II--Medicolegal implications and prevention)] Asphyxie périnatale et infirmité motrice d'origine cérébrale (II - Implications médico-légales et prévention). Gynecol Obstet Fertil 2011; 39(3): 146-73.
6. Diiulio R. The right stuff. Rtmagazine.com; April 2010: 20, 22, 24.
7. Mulligan M. Blood gas interpretation in the neonate – what do you need to know now? www.acutecaretesting.org. Jan 2013 as accessed 2015.
8. Christoph Aring, Chief Consultant, Children’s Hospital of St. Nicholas, Viersen, Germany. Case story: ‘Ongoing transcutaneous monitoring provides an ideal solution for tracking CO2 levels in premature babies, infants and young children with respiratory distress’. Radiometer Medical ApS publication 2014. Code no: 939-730.
9. Dr. Sherry E. Courtney, MD, Professor of Pediatrics, Arkansas Children’s Hospital, Maryland, AR, USA. Case story: ‘Continuous transcutaneous monitoring of pCO2 and pO2 supports in the prevention of cerebral damage for infants in intensive care units’. Radiometer Medical ApS publication 2014. Code no: 939-590.