Oxygen saturation and heart rate during delivery room resuscitation of infants <30 weeks' gestation with air or 100% oxygen.
BACKGROUND
Because of concerns about harmful effects of 100% oxygen on newborn infants, air has started to be used for resuscitation in the delivery room.


OBJECTIVE
To describe changes in preductal oxygen saturation (Spo(2)) and heart rate (HR) in the first 10 min after birth in very preterm infants initially resuscitated with 100% oxygen (OX(100)) or air (OX(21)).


METHODS
In July 2006, policy changed from using 100% oxygen to air. Observations of Spo(2) and HR before and after the change were recorded whenever a member of the research team was available to attend the birth.


RESULTS
There were 20 infants in the OX(100) group and 106 in the OX(21) group. In the OX(100) group, Spo(2) had risen to a median of 84% after 2 min and 94% by 5 min. In the OX(21) group, median Spo(2) was 31% at 2 min and 54% at 5 min. In the OX(21) group, 92% received supplemental oxygen at a median of 5 min; the Spo(2) rose to a median of 81% by 6 min. In the first 10 min after birth, 80% and 55% of infants in the OX(100) and OX(21) groups, respectively, had an Spo(2) > or =95%. Increases in HR over the first 10 min were very similar in the two groups.


CONCLUSIONS
Most very preterm infants received supplemental oxygen if air was used for the initial resuscitation. In these infants, the use of backup 100% oxygen and titration against Spo(2) resulted in a similar course to "normal" term and preterm infants. Of the infants resuscitated with 100% oxygen, 80% had Spo(2) > or =95% during the first 10 min. The HR changes in the two groups were very similar.
Dawson
J A
JA
Neonatal Services, The Royal Women's Hospital, 20 Flemington Road, Parkville, VIC 3052, Australia. jennifer.dawson@thewomens.org.au
Kamlin
C O F
CO
Wong
C
C
te Pas
A B
AB
O'Donnell
C P F
CP
Donath
S M
SM
Davis
P G
PG
Morley
C J
CJ
D000388:Air; D002985:Clinical Protocols; D003696:Delivery Rooms; D005260:Female; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000097:blood / Q000503:physiopathology / Q000628:therapy*; D008297:Male; D010092:Oximetry; D010100:Oxygen / Q000008:administration & dosage* / Q000097:blood; D010102:Oxygen Inhalation Therapy / Q000379:methods; D010313:Partial Pressure; D011446:Prospective Studies; D012131:Respiratory Insufficiency / Q000628:therapy*; D012151:Resuscitation / Q000379:methods*; D013997:Time Factors
D010100:Oxygen