Abstract
The objective of this study was to investigate the clinical applicability of pulse oximetry to measure haemoglobin oxygen saturation and heart rate in the first 20 min of life and to analyse the effect of pre- or postductal (hand, respectively, foot) fixation of sensors on oxygen saturation. Measurements were carried out on 53 newborn infants selected at random after delivery by caesarean section. Signal detection occurred significantly faster from the hand (50% after 1.3 min, 90% after 4 min) than from the foot (50% after 3.1 min, 90% after 9 min). Both fixation sites showed equally great sensitivity to motion. The heart rates from pulse oximetry recordings were up to 30% lower than those from ECG recordings. Saturation values from the hand were nearly always higher than those from the foot (median difference in the 5th min was 10%; between the 5th and 10th min it was 7%; no significant difference occurred after the 17th min). We conclude that pulse oximetry can be used for documenting oxygenation and right-to-left shunting in newborn infants during the first minutes of life in spite of limitations due to incomplete pulse wave detection and artifacts.
Similar content being viewed by others
Abbreviations
- HR:
-
heart rate
- SO2 :
-
haemoglobin oxygen saturation
References
American Academy of Pediatrics (1986) Use and abuse of the Apgar score. Pediatrics 78: 1148–1149
Bossi E, Meister B, Pfenninger J (1987) Comparison between transcutaneous PO 2 and pulse oximetry for monitoring O2. In: Huch A, Huch R, Rooth G (eds) Continuous transcutaneous monitoring. Plenum Press, New York, pp 171–176
Deckardt R, Steward DJ (1984) Noninvasive arterial hemoglobin oxygen saturation versus transcutaneous oxygen tension monitoring in the preterm infant. Crit Care Med 12: 935–939
Deckardt R, Schneider KTM, Graeff H (1987) Monitoring arterial oxygen saturation in the neonate. J Perinat Med 15: 357–360
Editorial (1989) Is the Apgar score outmoded? Lancet I: 591–592
Fanconi S, Doherty P, Edmonds JF, Barker GA, Bohn DJ (1985) Pulse oximetry in pediatric intensive care: comparison with measured saturations and transcutaneous oxygen tension. J Pediatr 107: 362–366
Gersony WM, Duc GV, Dell RB, Sinclair JC (1972) Oxygen method for calculation of right to left shunt: new application in presence of right to left shunting through the ductus arteriosus. Cardiovasc Res 4: 423–438
Harris AP, Sendak MJ, Donham RT (1986) Changes in arterial oxygen saturation immediately after birth in the human neonate. J Pediatr 109: 117–119
Hay WW Jr, Brockway JM, Eyzaguirre M (1989) Neonatal pulse oximetry: accuracy and reliability. Pediatrics 83: 717–722
House JT, Schultetus RR, Gravenstein N (1987) Continuous neonatal evaluation in the delivery room by pulse oximetry. J Clin Monit 3: 96–100
Jennis MS, Peabody JL (1987) Pulse oximetry: an alternative method for the assessment of oxygenation in newborn infants. Pediatrics 79: 524–528
Meier-Stauss P, Schmid ER, Weiss BM, König V, Huch R (1989) Anwendbarkeit und Grenzen der Pulsoximetrie bei Korrektur zyanotischer Herzvitien. Anaesthesist 38: 302–308
Neuman MR (1987) Pulse oximetry: physical principles, technical realization and present limitations. In: Huch A, Huch R, Rooth G (eds) Continuous transcutaneous monitoring. Plenum Press, New York, pp 135–144
Sendak M, Harris A (1987) Neonatal pulse oximetry in the delivery room. Review of recent investigations. Perinatol Neonatol 8–19
Southall DP, Bignall S, Stebbens VA, Alexander JR, Rivers RP, Lissauer T (1987) Pulse oximeter and transcutaneous PO 2 measurements in neonatal and paediatric intensive care. Arch Dis Child 62: 882–888
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Meier-Stauss, P., Bucher, H.U., Hürlimann, R. et al. Pulse oximetry used for documenting oxygen saturation and right-to-left shunting immediately after birth. Eur J Pediatr 149, 851–855 (1990). https://doi.org/10.1007/BF02072072
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF02072072