Monitoring oxygen saturation and heart rate during neonatal transition. comparison between two different pulse oximeters and electrocardiography



To compare the efficacy and reliability of two pulse-oximeters (POx) (Masimo Radical-7 and Nellcor Oxymax Bedside) and evaluate the feasibility of routine ECG monitoring during delivery room transition.

Study design

Prospective observational comparative study. Sixty newborns were connected simultaneously to both POxs and ECG monitor (as a gold standard for HR). Times to achieve a stable signal were compared. Heart rates were compared to simultaneous ECG.


A significant difference in times to stable signal was found: Mean, Median (Interquartile range) for Nellcor and Masimo, were 15, 8.5 (6–18) and 27, 12 (9–34) seconds, respectively. Compared to ECG, false bradycardia was displayed in 18 of 55 (35%) newborns by the Masimo POx and in no newborns by the Nellcor POx. Attaching the ECG monitor was feasible but consumed additional resources.


The time for achievement of a stable saturation reading in an uncomplicated resuscitation setting differed significantly between POxs.

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Fig. 1: Time to stable signal, by device.
Fig. 2: Correlation between measured HR in Pulse-oximeter and HR in ECG (beats per minute).
Fig. 3: Bland–Altman plot of the differences in Heart Rate between Nellcor Pulse-oximeter and ECG (beats per minute).


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Masimo provided a pulse-oximeter and sensors for the study; they requested to see the data before publication. Nellcor provided sensors. Both companies had no role in the design, execution, interpretation, or writing of the study. No other funding needed beyond the mentioned.

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Correspondence to Ruben Bromiker.

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Khoury, R., Klinger, G., Shir, Y. et al. Monitoring oxygen saturation and heart rate during neonatal transition. comparison between two different pulse oximeters and electrocardiography. J Perinatol (2020).

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