Document Detail


Observing the resuscitation of very preterm infants: Are we able to follow the oxygen saturation targets?
MedLine Citation:
PMID:  23376585     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: Since 2010, the European Resuscitation Council (ERC) guidelines advise oxygen saturation (SpO(2)) targets for the first 10minutes of resuscitation after birth. Unfortunately, the control of SpO(2) in newborn infants is difficult. AIM: To determine to what extent SpO(2) levels match the ERC targets during the resuscitation of very preterm infants, and how well the SpO(2) is kept within the high and low limits until the infants are transported to the NICU. METHODS: In a single-centre observational study, the SpO(2) and fraction of inspired oxygen (FiO(2)) were collected during the resuscitation of very preterm infants with a gestational age (GA) ≤30 weeks. RESULTS: A total of 78 infants were included [median (IQR): GA 27(4)/(7) (26-28(6)/(7)) weeks, birth weight 945g (780-1140)]. During the initial 10minutes after birth, large variations in SpO(2) were observed with deviations above the target [median (IQR)] of 4.4% SpO(2) (1.4-6.5), and below the target of 8.2% SpO(2) (2.8-16.0). After the first 10minutes, the SpO(2) levels were respectively above and below the limit for 11% (0-27) and 8% (0-23) of the time. CONCLUSION: During the resuscitation of very preterm infants, large deviations of the SpO(2) from the ERC targets are observed. During the first minutes of resuscitation the deviations were likely caused by an inability to control the SpO(2), whereas later deviations were due to weaning, pauses in respiratory support (i.e. intubation) and over exposure to oxygen. Changing the SpO(2) targets to a target range that depicts the acceptable deviation might be helpful in providing better respiratory support.
Authors:
Tom G Goos; Denise Rook; Anne C van der Eijk; Andre A Kroon; Gerhard Pichler; Berndt Urlesberger; Jenny Dankelman; Irwin K M Reiss
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-1-29
Journal Detail:
Title:  Resuscitation     Volume:  -     ISSN:  1873-1570     ISO Abbreviation:  Resuscitation     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2013-2-4     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0332173     Medline TA:  Resuscitation     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2013. Published by Elsevier Ireland Ltd.
Affiliation:
Department of Biomechanical Engineering, Faculty of Mechanical, Maritime and Materials Engineering, Delft University of Technology, Delft, The Netherlands; Department of Paediatrics, Division of Neonatology, Erasmus Medical Centre - Sophia Children's Hospital, Rotterdam, The Netherlands. Electronic address: T.Goos@erasmusmc.nl.
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