Time to achieve stable pulse oximetry values in VLBW infants in the delivery room

Gandhi, Bheru; Rich, Wade; Finer, Neil N.

doi:10.1016/j.resuscitation.2012.12.007

Cited by 23 publications

(11 citation statements)

References 11 publications

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“…ECG can pick up a continuous HR within 2 seconds of application, which is significantly faster than with a pulse oximeter (PO) [8],[9]. ECG readings were obtained from defibrillator analog output of a HR monitor (M3046A Phillips Medical Systems, Andover, MA).…”

Section: Methodsmentioning

confidence: 99%

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Umbilical Cord Milking Improves Transition in Premature Infants at Birth

et al. 2014

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BackgroundUmbilical cord milking (UCM) improves blood pressure and urine output, and decreases the need for transfusions in comparison to immediate cord clamping (ICC). The immediate effect of UCM in the first few minutes of life and the impact on neonatal resuscitation has not been described.MethodsWomen admitted to a tertiary care center and delivering before 32 weeks gestation were randomized to receive UCM or ICC. A blinded analysis of physiologic data collected on the newborns in the delivery room was performed using a data acquisition system. Heart rate (HR), SpO2, mean airway pressure (MAP), and FiO2 in the delivery room were compared between infants receiving UCM and infants with ICC.Results41 of 60 neonates who were enrolled and randomized had data from analog tracings at birth. 20 of these infants received UCM and 21 had ICC. Infants receiving UCM had higher heart rates and higher SpO2 over the first 5 minutes of life, were exposed to less FiO2 over the first 10 minutes of life than infants with ICC.ConclusionsUCM when compared to ICC had decreased need for support immediately following delivery, and in situations where resuscitation interventions were needed immediately, UCM has the advantage of being completed in a very short time to improve stability following delivery.Trial Registration ClinicalTrials.gov NCT01434732

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Section: Methodsmentioning

confidence: 99%

“…The SpO 2 ranges used are drawn from data for infants of 32–36 weeks gestation who did not require any intervention including provision of supplemental oxygen [10]. The 10 th and 50 th percentiles have been used as the upper and lower saturation targets [9], [11].…”

Section: Methodsmentioning

confidence: 99%

Umbilical Cord Milking Improves Transition in Premature Infants at Birth

et al. 2014

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“…[9][10][11] Data was analyzed and included if the baby's HR was <100 BPM within the first 90 s of resuscitation and the baby received mask positive pressure (PPV) during the first 2 min of resuscitation, the team used a Pedi-Cap with the initial mask ventilation and the baby was resuscitated on a warming bed with the data acquisition system available.…”

Section: Inclusion Criteriamentioning

confidence: 99%

“…1,2,[4][5][6][7][8] At UCSD Medical Center all babies that are at risk for requiring extensive resuscitation at birth are evaluated in a designated resuscitation suite outfitted with high definition audio/video monitoring along with multi-channel analog data capture. [9][10][11] In an ongoing quality improvement review of the recorded resuscitations, we observed that large increases in HR were associated with PediCap gold color change (PGC). CO 2 detection may be the first signal that there is adequate lung inflation, pulmonary blood flow and gas exchange.…”

Section: Introductionmentioning

confidence: 99%

Pedi-cap color change precedes a significant increase in heart rate during neonatal resuscitation

et al. 2014

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“…Our group has demonstrated that the median time to obtain a heart rate in infants with very low birth weight (<1,500 g) by oximetry was 67 seconds (interquartile range 50-93 seconds). 46 ECG, which derives from the electrical activity of the heart, is not dependent on circulation and so is less effected by the transitional state of the infant. In trials comparing oximetry to ECG, early application of ECG electrodes during infant resuscitation can provide the resuscitation team with a continuous reliable audible heart rate earlier, and its use may improve the timeliness of appropriate critical interventions when compared with pulse oximetry alone.…”

Section: Heart Ratementioning

confidence: 99%

Optimizing Care of the Preterm Infant Starting in the Delivery Room

2016

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Proficiency in the care of the preterm neonate is paramount to ensuring safe and quality outcomes. Here we review several simple interventions combined with supportive and informative monitoring that assists the care team in facilitating this critical transitional phase of the care of the preterm newborn. We will discuss the use of checklists, avoidance of early cord clamping, resuscitation during delayed cord clamping, early administration of caffeine soon after birth, and the use of additional monitoring (electrocardiogram, carbon dioxide and respiratory function) during resuscitation. This narrative review of the literature explores the current evidence and recommendations for optimal transition of the preterm infant starting in the delivery room. Team communication can be optimized by implementing the use of checklists and pre/postbriefs in the delivery room. Early use of caffeine in preterm infants may improve systemic blood flow and blood pressure. Delayed cord clamping and cord milking provide significant benefits when compared with immediate cord clamping. Optimizing transition at birth is one of the critical aspects of ensuring a good outcome for this vulnerable population.

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Time to achieve stable pulse oximetry values in VLBW infants in the delivery room

Cited by 23 publications

References 11 publications

Umbilical Cord Milking Improves Transition in Premature Infants at Birth

Umbilical Cord Milking Improves Transition in Premature Infants at Birth

Pedi-cap color change precedes a significant increase in heart rate during neonatal resuscitation

Optimizing Care of the Preterm Infant Starting in the Delivery Room

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