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Oxygen saturation and heart rate during delivery room resuscitation of infants <30 weeks’ gestation with air or 100% oxygen
  1. J A Dawson1,2,
  2. C O F Kamlin1,
  3. C Wong1,
  4. A B te Pas1,
  5. C P F O’Donnell3,
  6. S M Donath4,
  7. P G Davis1,2,
  8. C J Morley1,2,5
  1. 1
    Neonatal Services, The Royal Women’s Hospital, Melbourne, Australia
  2. 2
    Department of Obstetrics and Gynaecology, University of Melbourne, Australia
  3. 3
    National Maternity Hospital, Dublin, Ireland
  4. 4
    Clinical Epidemiology and Biostatistics Unit, Murdoch Children’s Research Institute, Melbourne, Australia
  5. 5
    Murdoch Children’s Research Institute, Melbourne, Australia
  1. Jennifer Dawson, Neonatal Services, The Royal Women’s Hospital, 20 Flemington Road, Parkville, VIC 3052, Australia; jennifer.dawson{at}thewomens.org.au

Abstract

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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Footnotes

  • Competing interests: None.

  • Patient consent: Parental consent obtained.

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