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

Abstract

Following concerns about harmful effects of 100% oxygen on newly born infants, we started resuscitation in the delivery room (DR) with air.

Objective: To describe preductal oxygen saturation (SpO₂) and heart rate (HR) changes 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, our DR policy changed from using 100% oxygen to air. We report our observations of SpO₂ and HR before and after the change when a member of the research team was available to attend the birth.

Results: We studied 20 infants initially resuscitated with 100% oxygen and 106 with air. In the OX₁₀₀ group SpO₂ rose to a median of 84% at two min and 94% by five min. In the OX₂₁ group, median SpO₂ was 31% at two min and 54% at five min. In the OX₂₁ group 92% received supplementary 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 both groups.

Conclusions: Most very preterm infants received supplemental oxygen if the initial resuscitation used air. 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 heart rate changes in the two groups were very similar.