DOI: http://dx.doi.org/10.18203/2349-3291.ijcp20163504

Comparison of pulse oximetry and colour: a better index of oxygenation in neonatal resuscitation

Akanksha Bansal, Ghanshyam Das, Ravi Ambey

Abstract


Background:Colour is an unreliable indicator of tissue oxygenation in the first few minutes of life. Little data is available about the progression of SpO2 in the new-borns delivered by normal vaginal route and caesarean section. So this study was conducted. The objectives of this study were to compare the new-born’s colour and oxygen saturation readings as an index of oxygenation and to find a more reliable one, and to compare the oxygen saturation profiles of the new-borns delivered by normal vaginal route and caesarean section.

Methods: This was a prospective observational study conducted over a period of one year in a tertiary care hospital on 500 newborns between 28-42 weeks, requiring routine care. Simultaneous assessment of colour and oxygen saturation readings was done at 30 second intervals after birth till 10 minutes of life.

Results:No significant difference has been found in the median SpO2 values of the new-borns requiring routine care that were pink and cyanosed since birth (p≥ 0.05). About 5.30 minutes required for most of the cyanosed new-borns to become pink (p≥ 0.05). Mean time±SD required for cyanosed new-born for getting pink was 1.96±1.33 minutes. Oxygen saturation rises slowly in new-borns delivered by caesarean section as compared to those delivered vaginally, especially in the first few minutes of life and more in preterm than term new-borns.

Conclusions:Unnecessary use of oxygen can be avoided by taking into account pulse oximetry. Separate sets of reference SpO2 should be used for new-borns delivered by normal vaginal route and caesarean section.


Keywords


Caesarean section, Colour, Cyanosis, New-born SPO2, Normal vaginal delivery, Oxygen saturation

Full Text:

PDF

References


Donnell CPF, Kamlin COF, Davis PG, Carlin JB, Morley CJ. Clinical assessment of infant colour at delivery. Arch Dis Child Fetal Neonatal Ed. 2007;92:465-7.

Perlman JM, Wyllie J, Kattwinkel J, Atkins DL, Chameides L, Goldsmith JP, et al. Neonatal resuscitation: International consensus on cardiopulmonary resuscitation and emergency cardiovascular care science with treatment recommendations. Pediatrics. 2010;126(5):1319-44.

Kattwinkel J, Perlman JM, Aziz K, Colby C, Fairchild K, Gallagher J, et al. Part 15: neonatal resuscitation: 2010 American heart association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation. 2010;122(18 Suppl 3):909-19.

East CE, Colditz PB, Begg LM, Brenneck SP. Update on intrapartum fetal pulse oximetry. Aust N Z J Obstet Gynaecol. 2002;42(2):119-24.

Dawson JA, Kamlin CO, Wong C, Tepas AB, Donnell CP, Donath SM, et al. Oxygen saturation and hert rate during delivery room resuscitation of infants <30 week’s gestation with air or 100% oxygen. Arch Dis Child Fetal Neonatal Ed. 2009;94(2):87-91.

Ballard JL, Novak KK, Driver M. A simplified score for assessment of fetal maturation of newly born infants. J Pediatr. 1979;95:769-74.

Dawson JA, Kamlin CO, Vento M, Wong C, Cole TJ, Donath SM, et al. Defining the reference range for oxygen saturation for infants after birth. Pediatics. 2010;125(6):1340-47.

Tiwari S, Tiwari S, Nangia S, Saili A. Oxygen saturation profile in healthy term neonates in the immediate post natal period. Int J Clin Pediatr. 2013:2(1):19-23.

Donnell CP, Kamlin CO, Davis PG, Morley CJ. Obtaining pulse oximetry data in neonates: a randomized crossover study of sensor application techniques. Arch Dis Child Fetal Neonatal Ed. 2005;90(1):F84-85.

Rabi Y, Yee W, Chen SY, Singhal N. Oxygen saturation trends immediately after birth. J Pediatr. 2006;148:590-4.

Kamlin CO, Donnell CP, Davis PG, Morley CJ. Oxygen saturation in healthy infants immediately after birth. J Pediatr. 2006;148(5):585-9.

Harris AP, Sendak MJ, Donham RT. Changes in arterial oxygen saturation immediately after birth in the human neonate. J Pediatr. 1986;109(1):117-9.

Dimich I, Singh PP, Adell A, Hendler M, Sonneenklar N, Jhaveri M. Evaluation of oxygen saturation monitoring by pulse oximetry in neonates in the delivery system. Can J Anaesth. 1991;38(8):985-8.

Hulsoore R, Shrivastav J, Dwivedi R. Normal oxygen saturation trend in healthy term newborns within 30 minutes of birth. Indian J Pediatr. 2011;78(7):817-20.