Feasibilty of Transcutaneous pCO₂ Monitoring During Immediate Transition After Birth-A Prospective Observational...

Background: According to recommendations, non-invasive monitoring during neonatal resuscitation after birth includes heart rate (HR) and oxygen saturation (SpO₂). Continuous transcutaneous monitoring of carbon dioxide partial pressure (tcpCO₂) may further offer quantitative information on neonatal respiratory status. Objective: We aimed to investigate feasibility of tcpCO₂ measurements in the delivery room during immediate neonatal transition and to compare the course of tcpCO₂ between stable term and preterm infants. Methods: Neonates without need for cardio-respiratory intervention during immediate transition after birth were enrolled in a prospective observational study. In these term and preterm neonates, we measured HR and SpO₂ by pulse oximetry on the right wrist and tcpCO₂ with the sensor applied on the left hemithorax during the first 15 min after birth. Courses of tcpCO₂ were analyzed in term and preterm neonates and groups were compared. Results: Fifty-three term (gestational age: 38.8 ± 0.9 weeks) and 13 preterm neonates (gestational age: 34.1 ± 1.5 weeks) were included. First tcpCO₂ values were achieved in both groups at minute 4 after birth, which reached a stable plateau after the equilibration phase at minute 9. Mean tcpCO₂ values 15 min after birth were 46.2 (95% CI 34.5-57.8) mmHg in term neonates and 48.5 (95%CI 43.0-54.1) mmHg in preterm neonates. Preterm and term infants did not show significant differences in the tcpCO₂ values at any time point. Conclusion: This study demonstrates that tcpCO₂ measurement is feasible during immediate neonatal transition after birth and that tcpCO₂ values were comparable in stable term and preterm neonates.