Target value of oxygen saturation during the first 10 min after birth

During neonatal resuscitation, careful oxygenation is needed. Pulse oximetry is recommended to evaluate the need for oxygenation, but it is not clear whether peripheral perfusion is adequate for the evaluation of arterial oxygen saturation (SpO₂ ). Additionally, there has been no study on the changes in SpO₂ immediately after birth in Japan, despite the indispensable need for definitive oxygenation criteria.

A prospective observational study was performed in neonates at gestational age 35-41 weeks. An SpO₂ measurement probe was attached to the neonates immediately after birth at the right palm or wrist, and the perfusion index (PI), pulse rate, and SpO₂ were measured until 10 min after birth.

Sixty neonates were examined. Stable PI was obtained soon after birth, preceding SpO₂ measurement. The median PI (%) was constant at approximately 1.3, and the median SpO₂ at 2-10 min was 70%, 81%, 82%, 87%, 89%, 92%, 92%, 94%, and 95%, respectively. The current target value for SpO₂ in the Neonatal Cardiopulmonary Resuscitation (NCPR) guideline in Japan is approximately the 25th percentile.

PI is stable and sufficient in the early postnatal period, meaning that peripheral perfusion is adequate for the measurement of SpO₂ . The current target SpO₂ used in the NCPR guidelines is at approximately the 25th percentile and is thought to be sufficient for meeting oxygenation criteria.