ORIGINAL ARTICLES

Oxygen saturation and heart rate during delivery room resuscitation of infants <30 weeks’ gestation with air or 100% oxygen

J A Dawson^1,2, C O F Kamlin¹, C Wong¹, A B te Pas¹, C P F O’Donnell³, S M Donath⁴, P G Davis^1,2, C J Morley^1,2,5

¹ Neonatal Services, The Royal Women’s Hospital, Melbourne, Australia
² Department of Obstetrics and Gynaecology, University of Melbourne, Australia
³ National Maternity Hospital, Dublin, Ireland
⁴ Clinical Epidemiology and Biostatistics Unit, Murdoch Children’s Research Institute, Melbourne, Australia
⁵ Murdoch Children’s Research Institute, Melbourne, Australia

Jennifer Dawson, Neonatal Services, The Royal Women’s Hospital, 20 Flemington Road, Parkville, VIC 3052, Australia; jennifer.dawson{at}thewomens.org.au

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 (SpO₂) and heart rate (HR) in the first 10 min after birth in very preterm infants initially resuscitated with 100% oxygen (OX₁₀₀) or air (OX₂₁).

Patients and methods: In July 2006, policy changed from using 100% oxygen to air. Observations of SpO₂ 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 OX₁₀₀ group and 106 in the OX₂₁ group. In the OX₁₀₀ group, SpO₂ had risen to a median of 84% after 2 min and 94% by 5 min. In the OX₂₁ group, median SpO₂ was 31% at 2 min and 54% at 5 min. In the OX₂₁ group, 92% received supplemental oxygen at a median of 5 min; the SpO₂ rose to a median of 81% by 6 min. In the first 10 min after birth, 80% and 55% of infants in the OX₁₀₀ and OX₂₁ groups, respectively, had an SpO₂ 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 SpO₂ resulted in a similar course to "normal" term and preterm infants. Of the infants resuscitated with 100% oxygen, 80% had SpO₂ 95% during the first 10 min. The HR changes in the two groups were very similar.

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