Thirty-seven children are still alive at home and four of them improved their respiratory condition so that it was possible to remove the tracheostomy tube. Our oldest patient has now achieved 15 years of mechanical ventilation at home.

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The International Guidelines for Neonatal Resuscitation recommend the assessment of heart rate, breathing and oxygenation to guide the resuscitation intervention. 1,2 Since 2010, pulse oximetry has replaced infant colour as measure of oxygenation in resuscitation guidelines because the latter has been shown to be an unreliable indicator of oxygen saturation. 1-3 However, the evaluation of infant colour remains the most used indicator of oxygenation in middle-and low-resource settings where pulse oximetry is often unavailable. 4,5 In such settings, oxygen administration is exclusively driven by clinical observation, but there is lack of information on whether assessing infant colour may be useful to healthcare providers in determining when to give supplemental oxygen. Therefore, this study aimed to evaluate the relationship between clinical assessment of infant colour and oxygen saturation at birth in a low-resource setting.

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