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

To study the time needed to obtain a reliable, functioning pulse oximeter signal during the resuscitation of very low birth weight (VLBW) infants.

This is a retrospective review of data from the resuscitation of preterm, VLBW infants at the University of California, San Diego Medical Center. Resuscitation teams consisted of a neonatal physician, a nurse, and respiratory therapist. Pulse oximetry was routinely used in all preterm deliveries. During resuscitation, the respiratory therapist attempted to place a pulse oximeter probe on the right hand or wrist immediately after birth. The BioPAC MP-150 Data Acquisition System was used to record analog data during the resuscitation, including the SpO2 value. From the analog tracing, the time at which a reliable pulse oximetry signal was obtained was determined.

50 VLBW (≤1500 g) preterm patients were studied. Mean gestational age was 27+4 weeks (range: 23-35 weeks). Mean birth weight was 920±287 g (range: 360-1445 g). Mean time to achieve functioning pulse oximetry was 79±42 s (range: 40-240 s). The median time was 67 s (interquartile range: 50-93 s). 86% of infants had a reliable SpO2 value obtained prior to 120 s of life.

Our data show that an experienced respiratory therapist can apply a pulse oximeter and achieve reliable SpO2 values for the majority VLBW infants by 120 s of life as recommended by current NRP guidelines.