Abstract
Background: Clinicians know about the dangers of hyperoxia and hypoxia in the delivery room and NICU. Less attention is paid to the period of transport and early stabilisation in the NICU. We aimed to investigate the time spent with SpO2 85-94% during the first hour after birth.
Method: A prospective observational study of clinical practice was undertaken. Infants < 32 weeks gestation were enrolled. A pulse oximeter (PO) sensor was applied to the right hand after birth, remaining connected until 60 minutes after birth. Clinical interventions were recorded during this time and matched with PO SpO2 data for analysis. Hyperoxic periods were only analysed when FiO2>0.21. Clinicians were unaware of the aims of the study.
Results: 32 infants were studied, mean (SD) birth weight 1101(330)g, gestational age 29(2) weeks. Median(IQR) time spent in the transport cot and NICU were 9(7-11)min and 30(27-33)min respectively, and time babies spent with SpO2>94% if receiving supplemental oxygen was 2.6(1.5-4.6)min and 5.4(2.1-9.1)min respectively.
The proportion of time with SpO2>94% during Transport and NICU was similar. Babies managed with CPAP compared to intubated infants had a greater proportion of time with SpO2>94% in transport and the NICU setting.
Conclusions: SpO2 measurements often fell outside the target range during the early postnatal period. Clinicians tolerate saturations higher than the “safe” range during the first hour after birth
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Thio, M., Simionato, L., Saraswat, A. et al. Transferring Infants < 32 Weeks' Gestation from the Delivery Room to the NICU. How Vigilant are we in Avoiding Hypoxia/Hyperoxia During the First “Golden Hour”?. Pediatr Res 70 (Suppl 5), 128 (2011). https://doi.org/10.1038/pr.2011.353
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DOI: https://doi.org/10.1038/pr.2011.353