Abstract
Background: Titration of supplemental O2 using oxygen saturation (SpO2) measured by pulse oximetry (PO) is becoming common in the delivery room. However there is little consensus to define “normoxiardquo;. Even brief hyperoxia is toxic for neonates.
Methods: In a prospective, observational study, we recorded preductal SpO2 every two seconds for ten minutes after birth. A Masimo Radical PO was placed on the infant's right hand/wrist immediately after birth. PO data (SpO2, and signal quality) were downloaded and analysed only when there were no alarm messages (low IQ signal, low perfusion, sensor off, ambient light). Infants were excluded if they received oxygen treatment or assisted ventilation in this time or they had a congenital anomaly that could interfere with transition. We used these data to construct centile charts.
Results: Data from 468 infants, of 25 to 42 weeks gestation, were used. At two minutes after birth the 10th, 50th and 90th centiles were 46%, 73% and 91% and at five minutes 73%, 89%, and 97%. Deciding the appropriate centile to target for oxygen treatment is a balance between treating those who need it and not giving it to those who don't. If the 50th centile was used this would lead to half of the normal population receiving oxygen unnecessarily. Choosing a lower centile (e.g. 10th) may be more appropriate.
Conclusions: The appropriate saturation target for infants receiving oxygen during resuscitation remains uncertain. Future trials could compare outcomes of infants resuscitated using different SpO2 targets.
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Dawson, J., Kamlin, C., Vento, M. et al. 341 Using Centile Charts Derived From Pulse Oximetry Measurements to Inform Oxygen Treatment in the Delivery Room. Pediatr Res 68 (Suppl 1), 176 (2010). https://doi.org/10.1203/00006450-201011001-00341
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DOI: https://doi.org/10.1203/00006450-201011001-00341