title: Use of a combined SpO₂/PtcCO₂ sensor in the delivery room.
abstract: Arterial oxygen saturation (SaO(2)) and partial arterial pressure of carbon dioxide (PaCO(2)) are important respiratory parameters in critically ill neonates. A sensor combining a pulse oximeter with the Stow-Severinghaus electrode, required for the measurement of peripheral oxygen saturation (SpO(2)) and transcutaneous partial pressure of carbon dioxide (PtcCO(2)), respectively, has been recently used in neonatal clinical practice (TOSCA(500Ò)Radiometer). We evaluated TOSCA usability and reliability in the delivery room (DR), throughout three different periods, on term, late-preterm, and preterm neonates. During the first period (period A), 30 healthy term neonates were simultaneously monitored with both TOSCA and a MASIMO pulse oximeter. During the second period (period B), 10 healthy late-preterm neonates were monitored with both TOSCA and a transcutaneous device measuring PtcCO(2) (TINA(Ò) TCM3, Radiometer). During the third period (period C), 15 preterm neonates were monitored with TOSCA and MASIMO after birth, during stabilization, and during transport to the neonatal intensive care unit (NICU). Blood gas analyses were performed to compare transcutaneous and blood gas values. TOSCA resulted easily and safely usable in the DR, allowing reliable noninvasive SaO(2) estimation. Since PtcCO(2) measurements with TOSCA required at least 10 min to be stable and reliable, this parameter was not useful during the early resuscitation immediately after birth. Moreover, PtcCO(2) levels were less precise if compared to the conventional transcutaneous monitoring. However, PtcCO(2) measurement by TOSCA was useful as trend-monitoring after stabilization and during transport to NICU.
authors.affiliation: Division of Neonatology, Department of Paediatrics, Catholic University of Sacred Heart, Largo Gemelli 8, I-00168 Rome, Italy. sererubor@hotmail.it
authors.forename: Serena Antonia
authors.initials: SA
authors.lastname: Rubortone
authors.forename: Maria Pia
authors.initials: MP
authors.lastname: De Carolis
authors.forename: Serafina
authors.initials: S
authors.lastname: Lacerenza
authors.forename: Iliana
authors.initials: I
authors.lastname: Bersani
authors.forename: Federica
authors.initials: F
authors.lastname: Occhipinti
authors.forename: Costantino
authors.initials: C
authors.lastname: Romagnoli
mesh_terms: D001785:Blood Gas Monitoring, Transcutaneous / Q000295:instrumentation* / Q000379:methods; D002245:Carbon Dioxide / Q000097:blood*; D003696:Delivery Rooms; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D010100:Oxygen / Q000097:blood*; D011446:Prospective Studies; D018709:Statistics, Nonparametric; D013997:Time Factors
chemical_list: D002245:Carbon Dioxide; D010100:Oxygen
keywords: TOSCA sensor; delivery room; neonate; oxygen saturation; partial pressure of carbon dioxide; pulse oximeter